Understanding Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease that affects the joints and other body systems.

It is characterized by persistent synovitis (inflammation of the synovial membrane that lines the joints), systemic inflammation, and autoantibodies (particularly to rheumatoid factor and citrullinated peptide antigens), leading to progressive, erosive destruction of the joint architecture, and function loss.

Here is a simplified explanation of key aspects of RA:

1. Cause: The exact cause is unknown, but it is believed to involve a combination of genetic and environmental factors. Certain genes may make individuals more susceptible to RA, and triggers such as smoking or infection could initiate the disease.

2. Symptoms: Symptoms typically include pain, swelling, and stiffness in multiple joints, especially the hands, wrists, and feet. Other symptoms can include fatigue, low-grade fever, and weight loss.

3. Diagnosis: Diagnosis is primarily based on clinical symptoms and is supported by laboratory tests such as rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPAs), as well as imaging studies.

4. Treatment: While there is currently no cure for RA, treatments aim to reduce inflammation to relieve symptoms, prevent joint and organ damage, improve physical function, and overall well-being. Treatment usually involves medications (like nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and disease-modifying antirheumatic drugs (DMARDs)), physical therapy, and in some cases, surgery.

5. Impact: RA can significantly impact quality of life, causing physical disability and comorbidities like cardiovascular disease. Early diagnosis and appropriate treatment can help manage the disease and its impact.

Sources: - Smolen, J. S., Aletaha, D., & McInnes, I. B. (2016). Rheumatoid arthritis. Lancet (London, England), 388(10055), 2023–2038. - McInnes, I. B., & Schett, G. (2011). The pathogenesis of rheumatoid arthritis. The New England journal of medicine, 365(23), 2205–2219. - Firestein, G. S. (2003). Evolving concepts of rheumatoid arthritis. Nature, 423(6937), 356–361.