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DEFINITION:

Rheumatoid arthritis (rue-ma-TOYD arth-write-tis) is a chronic disease, mainly characterized

by inflammation of the lining, or synovium, of the joints. It can lead to long-term joint damage,

resulting in chronic pain, loss of function and disability.

Rheumatoid arthritis (RA) progresses in three stages. The first stage is the swelling of the synovial

lining, causing pain, warmth, stiffness, redness and swelling around the joint. Second is the rapiddivision and growth of cells, or pannus, which causes the synovium to thicken. In the third stage, the

inflamed cells release enzymes that may digest bone and cartilage, often causing the involved joint to

lose its shape and alignment, more pain, and loss of movement.

Because it is a chronic disease, RA continues indefinitely and may not go away. Frequent flares in

disease activity can occur. RA is a systemic disease, which means it can affect other organs in the body.

Early diagnosis and treatment of RA is critical if you want to continue living a productive lifestyle.Studies have shown that early aggressive treatment of RA can limit joint damage, which in turn limits

loss of movement, decreased ability to work, higher medical costs and potential surgery.

RA affects 1.3 million Americans. Currently, the cause of RA is unknown, although there are several

theories. And while there is no cure, it is easier than ever to control RA through the use of new drugs,

exercise, joint protection techniques and self-management techniques. While there is no good time tohave rheumatoid arthritis, advancements in research and drug development mean that more people with

RA are living happier, healthier and more fulfilling lives

CAUSES:

The exact cause of rheumatoid arthritis (RA) currently is unknown. In fact, there probably isnt

an exact cause for RA. Researchers now are debating whether RA is one disease or several different

diseases with common features.

Immune System

We do know that the bodys immune system plays an important role in rheumatoid arthritis. In fact, RAis referred to as an autoimmune disease because people with RA have an abnormal immune system

response.

In a healthy immune system, white blood cells produce antibodies that protect the body against foreign

substances. People who have RA have an immune system that mistakes the bodys healthy tissue for a

foreign invader and attacks it.

One example of this miscommunication in the body is known as rheumatoid factor. Rheumatoid factor

is an antibody that is directed to regulate normal antibodies made by the body. It works well in people

with small quantities of rheumatoid factor. People with high levels of rheumatoid factor, however, mayhave a malfunctioning immune system. This is why your doctor often will request a test measuring

rheumatoid factor when trying to diagnose RA. In general, the higher the level of rheumatoid factor

present in the body, the more severe the disease activity is.

It is important to note that not all people with RA have an elevated rheumatoid factor and not all people

with an elevated rheumatoid factor have RA. The test also can come out negative if it is done too earlyin the course of the disease. Approximately 20 percent of people with RA will have a negative

rheumatoid factor test and some people who dont have RA will test positive.

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Learn more about the immune system.

Gender

Women get rheumatoid arthritis two to three times more often then men and their RA typically goesinto remission when they get pregnant. Women develop RA more often than expected in the year after

pregnancy and symptoms can increase after a baby is born. These facts lead researchers to believe that

gender might play a role in the development and progression of RA. Many are trying to understand theeffects female hormones might have in the development of RA. Currently, there are limited answers to

these questions. For more information on pregnancy and arthritis, see Pregnancy Prognoisis.

Genetics

Most researchers believe there are genes involved in the cause of RA. The specific genetic marker

associated with RA, HLA-DR4, is found in more than two-thirds of Caucasians with RA while it is

only found in 20 percent of the general population. While people with this marker have an increasedrisk of developing RA, it is not a diagnostic tool. Many people who have the marker either dont have

or will never get RA. While this marker can be passed from parent to child, it is not definite that if you

have RA, your child will too. Learn more about genetics and RA.

Infection

Some physicians and scientists believe that RA is triggered by a kind of infection. There is currently noproof of this. Rheumatoid arthritis is not contagious, although it is possible that a germ to which almost

everyone is exposed may cause an abnormal reaction from the immune system in people who already

carry a susceptibility for RA

EFFECTS?

Rheumatoid arthritis can start in any joint, but it most commonly begins in the smaller joints of

the fingers, hands and wrists. Joint involvement is usually symmetrical, meaning that if a joint hurts onthe left hand, the same joint will hurt on the right hand. In general, more joint erosion indicates more

severe disease activity.

Other common physical symptoms include:

Fatigue

Stiffness, particularly in the morning and when sitting for long periods of time. Typically, the

longer the morning stiffness lasts, the more active your disease is.

Weakness

Flu-like symptoms, including a low-grade fever

Pain associated with prolonged sitting

The occurrence of flares of disease activity followed by remission or disease inactivity

Rheumatoid nodules, or lumps of tissue under the skin, appear in about one-fifth of people with

RA. Typically found on the elbows, they can indicate more severe disease activity.

Muscle pain

Loss of appetite, depression, weight loss, anemia, cold and/or sweaty hands and feet

Involvement of the glands around the eyes and mouth, causing decreased production of tears

and saliva (Sjgrens syndrome)

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Advanced changes to look out for include damage to cartilage, tendons, ligaments and bone, which

causes deformity and instability in the joints. The damage can lead to limited range of motion, resulting

in daily tasks (grasping a fork, combing hair, buttoning a shirt) becoming more difficult. You also may

see skin ulcers and a general decline in health. People with severe RA are more susceptible to infection.

The effects of rheumatoid arthritis can vary from person to person. In fact, there is some growing belief

that RA isnt one disease, but it may be several different diseases that share commonalities.

PREVENTION

There are many theories based upon the assumption that arthritis can be prevented. Some ofthese theories include minimal activity, joint care, and strained muscle prevention. Attempting to

prevent arthritis is easy to do if certain precautions are taken on a regular basis. The first step towards

preventing arthritis is to think about your daily activities.Repetitive strain on your joints can lead to arthritis. Therefore, reducing the amount of repetitive

activity that you engage in is one way to potentially prevent arthritis. This can be done by paying

attention to any activities that you engage in. If you find that your joints ache every time you take part

in an activity, try to limit that activity.

In addition, keep track of those work positions that cause joint pain. A simple chair orcomputer

keyboard adjustment at work may be necessary in order to prevent joint strain. When it comes toexercise, try and avoid sports that cause joints to wear out. Sports such as running and heavy weight

lifting should be kept to a minimum.

Aside from activity related joint pain, it is also important to pay close attention to your weight. People

who are overweight often place unnecessary stress on joints. Thus, it is important to stay within yourideal weight range according to your height and age. If you are unsure of your ideal weight range,

speak with yourprimary carephysician. Your doctor should be able to determine whether or not you

are overweight.

There is also some speculation that drinking large amounts of water will help to keep joints lubricated.While thistheory is not backed by scientific fact, it is true that water will help to flush unwanted toxins

from your body. By replacing soft drinks and other drinks with water, you may effectively prevent

arthritis.

Lastly, take the time to engage in exercises that stretch your joints. Yoga is one activity that will help toincrease your flexibility, and relieve joint pressure. In fact, a mixture of cardiovascular,weight training,

yoga, and other sports is the best way to ensure that you do not place too much pressure on your joints.

While there's no disputing the fact that exercise is good for you, the type of exercise that you do may

contribute to arthritis. To prevent arthritis, take part in a wide variety of activities, eat healthy foods,and try to find ways to relieve joint stress. It is possible to prevent arthritis if you pay attention to your

body at all times

SOURCE:http://www.arthritis.org/disease-center.php?disease_id=31

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