WEBWATCH - Rheumatoid Arthritis
by Shirley Butler

Definition of Rheumatoid Arthritis: A chronic inflammatory disease that primarily affects the joints and surrounding tissues but also affects other organ systems within the body. It is a systemic disorder.

Causes, incidences, and risk factors

The cause of rheumatoid arthritis (RA) is unknown. In fact, it is possible that there is no single cause of RA. Infectious, genetic, and hormonal factors may play a role. The disease can occur at any age, but the peak incidence of disease onset is between the ages of 25 and 55. The incidence increases with age. Women are affected 2.5 times more often than men. Approximately 1-2% of the total population is affected. The course and the severity of the illness can vary considerably between patients. Most importantly, RA can eventually affect an individual's functional ability to perform daily activities and overall quality of life.

The onset of the disease is usually gradual, with fatigue, morning stiffness lasting more than one hour, diffuse muscular aches, loss of appetite, and weakness. Eventually, joint pain appears, with warmth, swelling, tenderness, and stiffness of the joint after inactivity. Joint involvement in RA affects both sides of the body equally; the arthritis is therefore referred to as symmetrical. Wrists, fingers, knees, feet an ankles are the most commonly affected joints. Severe disease is associated with larger joints that contain more synovium (joint lining). When the synovium becomes inflamed, it secretes more fluid and then becomes swollen. Later, the cartilage becomes rough and pitted. The underlying bone eventually becomes affected. Joint destruction begins 1-2 years after the appearance of the disease. Characteristic deformities result from cartilage destruction, bone erosions, and tendon inflammation and rupture.

Other features of the disease that do not involve the joints may occur. Rheumatoid nodules are painless, hard round or oval masses that appear under the skin, usually on pressure points such as the elbow or Achilles tendon. These are present in about 20% of cases. On occasion, they appear in the eye where they sometimes cause inflammation. If they occur in the lungs, inflammation of the lining of the lung (pleurisy) may occur, causing shortness of breath.

Prevention

Rheumatoid arthritis has no known prevention. However, it is often possible to prevent further damage of the joints with proper early treatment.

Symptoms

Fatigue , general discomfort, uneasiness, or malaise,loss of appetite and low-grade fever. Joint pain, joint stiffness and joint swelling ~ ~ usually symmetrical ~ ~ may involve wrist pain, knee pain, elbow pain, finger pain, toe pain, ankle pain, or neck pain. There may be limited range of motion morning stiffness lasting more than one hour, deformities of hands and feet, round, painless nodules under the skin, skin redness or inflammation, paleness, swollen glands, eye burning, itching and discharge.