What Exactly Is Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune disease, meaning that, for whatever reasonprobably some combination of genetic and environmental factors or even hormonal changesa persons immune system goes rogue. Instead of destroying germs, their infection-fighting white blood cells mount an assault on healthy tissue surrounding the joints. And that process causes joint inflammation and subsequent pain and symptoms. People will notice theyre puffy or swollen and stiff and they dont feel well, Dr. Bykerk notes.
RA symptoms can wax and wane over time, which can make it tough, at least initially, to figure out what your body is telling you. It might start with a few weeks of pain in your wrists or a sore shoulder before symptoms fade away. You might think you have the flu. And just when you thought you were on the mend, another wave of achiness and exhaustion flares up. However, for other people, RA symptoms hit in one fell swoop.
I woke up one morning, and I couldnt get out of bedboom, thunderbolt
Few people know that better than Tammi Shlotzhauer, MD, a practicing rheumatologist in Rochester, New York, and author of Living with Rheumatoid Arthritis. I woke up one morning, and I couldnt get out of bedboom, thunderbolt, says Dr. Shlotzhauer. She, of all people, knew what RA looked like and felt like, but it took several months to heed the warning signs, get diagnosed, and start following her own advice. And when I did that, I got it under great control, she says.
What Treatment Options Are Available For Ra
There are medications that help manage RA symptoms and control inflammation, such as NSAIDs, corticosteroids, disease-modifying anti-rheumatic drugs, and biologics. However, there are non-medication treatment options as well. Non-pharmacologic treatment options include rest, exercise, physical and occupational therapies, dietary management, and, in some cases, surgery.
Signs And Symptoms Of Osteoarthritis
The symptoms experienced by patients with osteoarthritis can be easily managed despite the joint damage being usually irreversible.
- Aching pain on the joints during activities or after participating in a long activity
- Stiffness of the joints and muscle weakness that is usually experienced after a long rest or after waking up in the morning or also known as morning sickness
- Heberdens Node and Bouchards Node are outgrowths on the fingers found in the distal interphalangeal and proximal interphalangeal joints are prominent and very noticeable.
- There is tenderness when these bony outgrowths are touched.
- Crepitus or crackling sound when flexing the joints due to the rubbing of the bones.
- The joints are uneven, hard, bony, and swelling.
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How Is Rheumatoid Arthritis Diagnosed
The diagnosis of rheumatoid arthritis is based on a combination of factors, including:
- Morning stiffness that lasts at least one hour and has been present for at least six weeks
- Swelling of three or more joints for at least six weeks
- Swelling of the wrist, hand, or finger joints for at least six weeks
- Swelling of the same joints on both sides of the body
- Changes in hand x-rays that are hallmarks of rheumatoid arthritis
- Rheumatoid nodules of the skin
- Blood test that is positive for rheumatoid factor* and/or anti-citrullinated peptide/protein antibodies
* The rheumatoid factor may be present in people who do not have rheumatoid arthritis. Other diseases can also cause the rheumatoid factor to be produced in the blood. A test called CCP antibody can sometimes help to determine whether the rheumatoid factor antibody is due to rheumatoid arthritis or some other disease. This is why the diagnosis of rheumatoid arthritis is based on a combination of several factors and NOT just the presence of the rheumatoid factor in the blood.
It is also important to note that not all of these features are present in people with early rheumatoid arthritis, and these problems may be present in some people with other rheumatic conditions.
In some cases, it may be necessary to monitor the condition over time before a definitive diagnosis of rheumatoid arthritis can be made.
The Signs And Symptoms Of Rheumatoid Arthritis Are As Follows:
- Inflammation, pain and tenderness in the joints, usually the shoulders, the elbows, the wrists, the fingers, the ankles or the toes
- Morning stiffness
- Stiffness after sitting for a long period
- Swelling in at least one joint
- Pain in at least one joint
- Deformity of joints
- Joints tender to the touch
- Lumps or nodules under the skin on the forearm below the elbow
- Swollen lymph glands
- X-ray evidence of rheumatoid arthritis
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What Are Common Symptoms Of Rheumatoid Arthritis
- Stiffness, especially in the morning
- Warmth, according to the U.K. National Health Service
Sometimes, systemic symptoms precede joint symptoms by weeks to months and may be an early sign of RA.
- Swan-neck, in which the joint at the base of the finger and the outermost joint bend in while the middle joint straightens
- Hitchhikers thumb , in which the joint at the base of the thumb bends in and the joint below the thumbnail bends backward
- Hammertoe , in which the toes either bend up from the joints at the ball of the foot, down at the middle joints, or down at the top toe joints
- Boutonniere, in which the joint nearest the knuckle bends toward the palm and the outer joint bends away from it, per OrthoInfo
Effective Treatments For Ra Are Available
But the good news is that in 2021, the treatments for rheumatoid arthritis are better than ever. There are phenomenal therapies for RA, and most patients will have a completely normal life, provided they take their medications, says Vinicius Domingues, MD, a rheumatologist in Daytona Beach, Florida, and a medical advisor to CreakyJoints, a support, education, advocacy, and research organization for people living with arthritis and rheumatic disease. Here are five important things to note about disease progression:
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Articles On Rheumatoid Arthritis
Rheumatoid arthritis symptoms are different for each person who has this long-term disease.
Some people have long periods with few or no symptoms. Others feel it for months at a time in an uptick of disease activity called a flare.
Most people have lasting problems with episodes of more severe disease. New and earlier treatment is changing the overall picture, though. More people are having low disease activity or even remission.
Other Manifestations Of Ra
While joint issues are the most common symptoms of RA, several other health problems are common in people with RA. This can be related to inflammation in the body, chronic pain, side effects of the drugs often used to treat RA, or a combination of factors. These symptoms and conditions include:5,7,8
Bone loss and muscle weakness RA may decrease bone density and weaken muscles around the joints
Skin problems Small lumps, known as rheumatoid nodules, may appear beneath the skin. They are most common on the elbow but may occur on other pressure points on the back of the head, base of the spine, and tendons of the hands
Vision problems Inflammation in the eyes can cause redness, pain, and vision issues. Some people also experience Sjögrens syndrome, a condition that causes dry eyes and dry mouth.
Lung disease Inflammation affecting the lungs may cause a chronic cough and shortness of breath
Pericarditis This is the term used for inflammation of the tissue that lines the chest cavity and surrounds the heart. It can cause chest pain and breathing difficulties.
Vasculitis This term describes inflammation of the blood vessels. It can cause a shortage of blood supply to the organs leading to tissue and organ damage throughout the body.
Nerve issues Some people with RA develop complications that affect both the central and peripheral nervous systems.
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Ra Progression: What Are The Signs Of Rheumatoid Arthritis Progression
If you suspect you have rheumatoid arthritis or have been recently diagnosed with RA, you will likely have lots of questions and be feeling uncertain about what this disease means for your future. What is the normal RA progression? Will my symptoms get worse? How can I manage the disease? Do I have to have a surgery?
These are all frequent questions asked by RA sufferers. The reality though is that each patient will experience a unique progression of this disease. RA progression depends on multiple unpredictable variables. Because it is still unclear exactly what triggers RA, it can be nearly impossible to predict an exact outcome.
Below is some general information about what to expect as well as the different stages of RA including the advanced condition known as progressive rheumatoid arthritis.
When Do The Signs Of Ra Start
Rheumatoid arthritis affects 1.3 million people in the United States. It is 2.5 times more common in women. RA often affects people between the ages of 20 and 50, but young children and older adults can also have RA.
Younger adults and older adults, who make up a smaller number of the people RA, often have a different disease course than people in middle adulthood.
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Ra Symptoms: How Do You Diagnose Rheumatoid Arthritis
Rheumatoid arthritis symptoms range from obvious physical symptoms of joint damage and joint deterioration to less obvious signs and symptoms that mimic other illnesses. This is what makes rheumatoid arthritis so difficult for healthcare providers when it comes to diagnosing and prescribing treatment, especially in its early stages.
Blood Tests For Rheumatoid Arthritis
There are several types of blood tests that help your healthcare provider or rheumatologist determine whether you have RA. These tests include:
- Rheumatoid factor test. The RF blood test checks for a protein called rheumatoid factor. High levels of rheumatoid factor are associated with autoimmune diseases, especially RA.
- Anticitrullinated protein antibody test . This test looks for an antibody thats associated with RA. People who have this antibody usually have the disease. However, not everyone with RA tests positive for this antibody. The anti-CCP Ab is more specific for RA than the RF test
- Antinuclear antibody test. The antinuclear antibody panel tests your immune system to see if its producing antibodies. Your body may make antibodies as a response to many different types of conditions, including RA.
- Erythrocyte sedimentation rate. The ESR test helps determine the degree of inflammation in your body. The result tells your doctor whether inflammation is present. However, it doesnt indicate the cause of the inflammation.
- C-reactive protein test. A severe infection or significant inflammation anywhere in your body can trigger your liver to make C-reactive protein. High levels of this inflammatory marker are associated with RA.
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Hand Deformities From Rheumatoid Arthritis
Evidence suggests that hand deformities commonly occur in the first year of rheumatoid arthritis if it goes untreated.2 Moreover, people who experience hand deformities in the first year tend to have more severe cases of the disease. 3
In some cases, hand deformities can be treated. In addition, new rheumatoid arthritis medications have reduced the likelihood that rheumatoid arthritis will cause permanent deformities.
The most common finger and wrist deformities are described below.
Hallmark Symptoms Of Ra In The Fingers Thumbs And Wrists
Recognizing the signs and symptoms of RA in the hands can help distinguish rheumatoid arthritis from other types of arthritis that affect the hand, such as osteoarthritis and psoriatic arthritis. Keep in mind that these symptoms may be accompanied by pain in other joints as well as fever, fatigue, and a general feeling of being unwell.
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What Are The Symptoms Of Rheumatoid Arthritis
The symptoms of rheumatoid arthritis include the following:
- Stiffness, especially in the morning or after sitting for long periods
Rheumatoid arthritis affects each person differently. In most people, joint symptoms may develop gradually over several years. In other people, rheumatoid arthritis may proceed rapidly. A few people may have rheumatoid arthritis for a limited period of time and then go into remission .
Cartilage normally acts as a shock absorber between the joints. Uncontrolled inflammation causes the destruction and wearing down of the cartilage, which leads to joint deformities. Eventually, the bone itself erodes, potentially leading to fusion of the joint . This process is aided by specific cells and substances of the immune system, which are produced in the joints but also circulate and cause symptoms throughout the body.
Jak Inhibitors And Ra
- Tofacitinib is the first in a new class of “small molecule” medications used to treat rheumatoid arthritis called JAK inhibitors. Tofacitinib is a treatment for adults with moderate to severe active RA in which methotrexate was not very effective. Patients can take tofacitinib with or without methotrexate, and this prescription drug is taken by mouth two times a day. Tofacitinib is a “targeted” drug that only blocks Janus kinase, special enzymes of inflammation, within cells. This is why it is referred to as a JAK inhibitor. JAK inhibitors are not used with biologic medications.
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Who Should Diagnose And Treat Ra
A doctor or a team of doctors who specialize in care of RA patients should diagnose and treat RA. This is especially important because the signs and symptoms of RA are not specific and can look like signs and symptoms of other inflammatory joint diseases. Doctors who specialize in arthritis are called rheumatologists, and they can make the correct diagnosis. To find a provider near you, visit the database of rheumatologistsexternal icon on the American College of Rheumatology website.
Your Doctor Can’t Fully Appreciate Potential New Symptoms Via Telemedicine
In the COVID-19 pandemic era, people with rheumatoid arthritis cant always make it into the doctors office for a physical visit. But a telemedicine, or telehealth, appointment, which is unquestionably better than not checking in with health professionals at all, may not detect that the disease is progressing as well as an in-person visit.
Domingues says that rheumatologists should definitely notice if joints are swollen and warm to the touch in an office consultation signs of active inflammation but they may not catch the severity of those symptoms on a computer screen. If were not physically examining them, the communication between doctors and patients needs to be even better, Domingues says. He says to make sure that you mention how your joints feel when you wake up, how much stiffness you experience in the morning and for how long, if youre able to make a full fist early in the day, and if you see red, warm, or swollen joints. Those are the pivotal signs of worsening RA, he says.
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Questions For Your Doctor
- How do I know if my joint pain is caused by rheumatoid arthritis?
- Does RA run in families?
- What medicines would work best for me, and what are the side effects?
- Is there anything I can do to prevent flare-ups of RA?
- What are the pros and cons of surgery to treat RA?
- Does RA affect my life expectancy?
Maximizing Imaging Procedure Use
The amount of data obtained in a single MR or CT scan is very extensive. Some of the data that radiologists discard could save patients time and money, while reducing their exposure to radiation and risk of complications from invasive procedures. Another approach for making the procedures more efficient is based on utilizing additional constraints, e.g., in some medical imaging modalities one can improve the efficiency of the data acquisition by taking into account the fact the reconstructed density is positive.
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Medical Imaging In The Cloud
There has been growing trend to migrate from on-premise to a PACS. A recent article by Applied Radiology said, “As the digital-imaging realm is embraced across the healthcare enterprise, the swift transition from terabytes to petabytes of data has put radiology on the brink of . Cloud computing offers the imaging department of the future the tools to manage data much more intelligently.”
Rheumatoid Arthritis: Causes Symptoms Treatments And More
Rheumatoid arthritis is an inflammatory type of arthritis that can causes joint pain, swelling and damage. Learn what causes RA and how to treat it.
Rheumatoid arthritis causes joint inflammation and pain. It happens when the immune system doesnt work properly and attacks the lining of the joints . The disease commonly affects the hands, knees or ankles, and usually the same joint on both sides of the body. But sometimes, RA causes problems in other parts of the body as well, such as the eyes, heart and circulatory system and/or lungs. For unknown reasons, more women than men get RA, and it usually develops in middle age. Having a family member with RA increases the odds of developing RA.
In a healthy person, the immune system fights invaders, such as bacteria and viruses. With an autoimmune disease like RA, the immune system mistakes the bodys cells for foreign invaders and releases inflammatory chemicals that attack, in the case of RA, the synovium. Thats the tissue lining around a joint that produces a fluid to help the joint move smoothly. The inflamed synovium gets thicker and makes the joint area feel painful and tender, look red and swollen and moving the joint may be difficult.
Researchers arent sure why some people develop RA. They think that these individuals have certain genes that are activated by a trigger in the environment, like a virus or bacteria, or physical or emotional stress or some other external factor.
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