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Mary Jo Cameron

Professor B

SCI 154

25 January 2014

Rheumatoid Arthritis

An x-ray of deformed joints due to rheumatoid arthritis is a hard sight to see when the

disease leads to progressive deformed knees and shoulders. According to the National Institutes

of Health, about 1.5 million people in the US suffer from rheumatoid arthritis (NIH, 2013). As a

progressive disease, the prognosis is not very clear due no known cure. Rheumatoid arthritis has

many different causes, signs and symptoms, laboratory techniques to diagnosis and current

research studies to further improve care of the disease.

Rheumatoid Arthritis is a disease in which the body begins to attack its healthy tissues

such as the synovial fluid, which is the lining of the joints. This causes the fluid to build in the

joints and cause swelling for the individual with the disease. It also begins to attack some of the

bodies’ organs such as the skin, lungs, and eyes. Normally your body’s immune system would

attack any foreign cells such as a virus’s or bacteria, but in this case, RA is an autoimmune

disease that attacks the healthy cells. According to www.arthritis.org, many people note that

their symptoms get worse over time, while others stop feeling symptoms and go into remission.

RA is a chronic disease meaning that it is incurable. Patients living with RA can only find ways

to help deal with pain while researchers try to find a cure for this disastrous disease.

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Through years of studying Rheumatoid Arthritis, researchers have yet to find the

apparent cause for RA. Although there isn’t an exact cause, many researchers have found that

there are numerous risk factors that can lead to RA. After years of studies on RA, scientist have

been able to come to the conclusion that age, gender, infection, genes, and hormones along with

proteins play a major role on discovering who has RA. Rheumatoid Arthritis can occur at any

age, but it has been seen more in middle-aged people. It has also been proven that RA is 2 to 3

times more likely to be seen in women. “A protein in the body called tumor necrosis factor

(TNF) may play a role as well. Some people with RA have too much of the protein TNF in the

affected area of the body. TNF causes inflammation in the joints, and the inflammation is what

leads to the pain and stiffness of RA” (Humira, 2013). According to Arthriti.org, in September

of 2007, researcher Peter K. Gregersen discovered 5 total genes that are almost 100% linked to

RA. According to a health community website, studies have shown that pregnancy has an affect

on RA. It is believed that once a woman has a child, the changing of the bodies hormones

influence the disease progression along with the development.

When a person is affected by Rheumatoid arthritis (RA), there are very specific signs and

symptoms that occur. Though RA is an immune disorder only diagnosed through a variety blood

tests, the symptoms are very well pronounced. In the early stages, RA affects the smaller joints

and affect both sides of the body (Mayo Clinic, 2013). The smaller joints affected usually starts

in the joints of the hands and feet. The smaller joints are easier to attack. The disease will affect

symmetrical sides of the body due to the antibodies slowly attacking the body. Rheumatoid

nodules will also appear under the skin of the arms (Mayo Clinic). These firm bumps form as it

affects the tissues of the arm. As the disease progresses, the symptoms will often effect the

knees, ankles, elbows, and shoulders (Mayo Clinic, 2013). As the bigger joints are effected, the

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body becomes harder to manage and move. The person that is infected will often tend to “have

pain and stiffness for more than thirty minutes in the morning, or after a long rest” (NIH, 2013).

This is due to a long time not moving the joints leading to a stiffness.

Rheumatoid Arthritis can act in many different ways depending on the person. The joints

will be tender, warm, and swollen. There is “flares” in which there are times of increased

activity and also times of remission (Mayo Clinic, 2013). Flares will cause the body to have

high fevers and fatigue due to the disease attacking the body at a higher rate. The remission

period will make the disease seem silent in a way that it does not cause pain, swelling, or

stiffness. As the disease takes its course, the joints will start to deform and shift out of place

(Mayo Clinic, 2013). The fingers will be affected first in most cases leading to a slanted form at

the proximal interphalangeal joint. Rheumatoid Arthritis is a disease that becomes progressively

worse with flares and states of remission as well as chronic, pain, swelling, and stiffness.

Diagnosing Rheumatoid Arthritis is very difficult due to the signs and symptoms being

very close to other diseases. While examining for RA, a doctor will check for swelling, redness,

and warmth as well as checking the reflexes and muscle strength (Mayo Clinic, 2013). They

check for this because that is the number one sign to joint issues. Also, they will check the

muscle strength since RA does not only affect the joints, but also the tissues surrounding them.

The doctor will then order multiple blood tests to be done, testing the erythrocyte sedimentation

rate (Mayo Clinic, 2013). When this rate is increased, it indicates the presence of an

inflammatory process in the body. They also do other blood tests testing the rheumatoid factor

and antibodies correlated with it. Also, after diagnosis, the doctor will have the patient get

regulatory x rays to track the progression of RA on their joints (Mayo Clinic, 2013). The

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symptoms and multiple tests are factored and compared to diagnosis the patient with rheumatoid

arthritis.

Though Rheumatoid arthritis is incurable, there is many ways to help the inflammation

and irritation that is tagged along with this disease. Physical therapy is very common among

those who are affected (NCBI, 2013). The constant range of motion work will help the joints

stay open and prevent hardening or deformation. In severe cases, the doctor could perform

multiple surgeries. Some will require a synovectomy, removing the joint lining to decrease

inflammation (NCBI, 2013). This would open up the joint, allowing for more movement. Also,

if the condition does worsen to the point where a large joint cannot be used (i.e. hip, knee), the

doctors may want to perform a replacement to allow for movement (NCBI, 2013). These

extreme cases of RA, are debilitating, but with the replacement, can add better quality of life.

There are many options for conservative rehabilitation through physical therapy but also very

invasive procedures that will help with managing the disease.

On December 18th, 2010, rheumatologist Dr. Christopher Atkins made a remarkable

finding. During a study on Rheumatoid arthritis, the Victoria-based researchers came across a

groundbreaking discovery that could potentially help find a cause for RA. Janine Pigeon, a 77-

year-old woman was a subject to the study. Researchers believe that she was given RA through

her unborn soon. After creating a hypothesis, scientist have figured out that through a

phenomenon called microchimerism, mother cells and baby cells can travel in both directions

passing through the placenta and residing within the opposite body for decades or even lifetimes.

With this begin said, microchimerism has been connected to numerous autoimmune diseases.

According to Lexis Nexis Academic, following these findings, doctors analyzed Janine’s nodules

formed by the RA from her knuckle. After testing this nodule, it was found to contain male

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DNA at the center. The researchers also found out that the DNA was from one of Janine’s sons.

This helps to prove that foreign genetic material could have triggered the immune response that

set off the RA. This little piece of discovery will be able to help scientist figure out of RA

develops in a person and whether or not if it could be curable one day.

As a progressive disease, Rheumatoid arthritis affects many people’s lives when the body

attacks the joints and tissues as if they were foreign. Though the cause and cure is yet to be pin

pointed, the health care field is working on figuring out these unknowns. The causes and

symptoms are backed up by vague tests to the blood and bones; therefore, leading to more

research to become more knowledgeable in the world of Rheumatoid Arthritis.

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Bibliography

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2014.

"Rheumatoid Arthritis." Diseases and Conditions. Mayo Clinic, 27 July 2013. Web. 25 Jan.

2014.

"Rheumatoid Arthritis." Handout on Health:. National Institute of Health: Arthritis, Apr. 2013.

Web. 24 Jan. 2014.

Teitel, Ariel. "Rheumatoid Arthritis." Rheumatoid Arthritis. U.S. National Library of Medicine,

02 Feb. 2012. Web. 25 Jan. 2014.

"The Genetics Behind Rheumatoid Arthritis." The Genetics Behind Rheumatoid Arthritis.

Arthritis Foundation, 5 Sept. 2007. Web. 25 Jan. 2014.

Thomas, Donald E. "Rheumatoid Arthritis Risk Factors & Causes." - Rheumatoid Arthritis.

Health Communities, 1 July 2006. Web. 25 Jan. 2014.