RA: The Autoimmune Form of Inflammatory Arthritis
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- Rheumatoid Arthritis (RA) is an autoimmune disease affecting the joints. Autoimmune diseases are a result of the immune system attacking a natural part of our bodies, after mistakenly identifying it as a foreign invader, such as a virus, bacteria, fungi or allergen. Medical science has yet to find a cause for this type of immune system response (autoimmunity). In the case of RA, this mistaken identity is directed against the joints in the body, which are the areas where bones are separated by cartilage, fibrous tissue or synovial fluid. The joints of the musculoskeletal system are designed so that bones and muscles are working together, to give the body mobility. With rheumatoid arthritis, the immune cells, called antibodies, build in the joints and the joint lining becomes inflamed, which causes swelling and stiffness. Normally, the inflammation goes away after the body has fought off an infection caused by a virus, bacteria, fungi or virus, however, rheumatoid arthritis is a chronic condition, which means the autoimmune process is ongoing.
- These are the symptoms of Rheumatoid Arthritis. Symptoms include redness and swelling around the affected joints, low grade fever, loss of appetite and weight loss, and mild to severe fatigue. Over time, the joints can become deformed after cartilage is destroyed, and the unprotected bone begins to wear away (osteoporosis). Joints can become immobile or stuck in one position, which is called a "contracture." Rheumatoid Arthritis can progress to other areas of the body, such as blood vessels, causing a condition called vasculitis (inflamed blood vessels), lung disease, and anemia (low red blood cells). Having Rheumatoid Arthritis also puts a person at higher risk for developing other autoimmune diseases. Many patients with Rheumatoid Arthritis also develop anxiety and depression, due to the stress caused by ongoing symptoms. Some patients' symptoms are not ongoing, but are intermittent, and they will experience flares of symptoms rather than having constant (chronic) ones. When Rheumatoid Arthritis symptoms are experienced suddenly, and are severe (including a high grade fever), this is referred to as "Still's Disease." Some patients also develop small tumors under the skin, around the area of the affected joints, called "Rheumatoid Nodules."
- Features of Rheumatoid Arthritis that help distinguish it from other forms of arthritis. A feature of Rheumatoid Arthritis that helps in identifying it is the fact that it affects joints in the body symmetrically. This means that each side of the body will be affected equally. If a particular joint on one hand of the body is affected, the joint on the other hand will be equally affected. If the hip on one side is affected, so will the hip on the opposite side. Rheumatoid Arthritis more commonly affects the joints in the hands and feet, as well as the shoulders, jaw, hips and knees. Other types of arthritis however can affect only one joint on one side of the body. Other types of arthritis also do not cause the affected person to run a fever as in Rheumatoid Arthritis and the redness and swelling of the joints will not be as severe.
- Medical blood lab tests that also help diagnoses Rheumatoid Arthritis. One of the more commonly used blood lab tests used to identify Rheumatoid Arthritis, is one called "Rheumatoid Factor," which is a blood test used to detect the antibodies that cause the disease. When the blood level of this substance is found to be elevated above the normal range, this can indicate RA. An ESR blood level may also be ordered, which stands for the "Erythrocyte Sedimentation Rate." With this blood test, a lab will test for inflammation levels in the body; systemic (body-wide) inflammation can also indicate RA. Since these blood tests can sometimes indicate other diseases as well, there are additional tests that also help to identify Rheumatoid Arthritis. These include drawing a sample of the patient's synovial fluid (found between one or more of the affected joints) and examining it under a microscope for signs of inflammation. If there are rheumatoid nodules also present around affected joints, these can be biopsied. X-rays may also be ordered; to examine how much damage has occurred to affected joints.
- What are the treatments for Rheumatoid Arthritis? Treatments for RA include anti-inflammatory drugs, such as over-the-counter types including ibuprofen, naproxen sodium, and indomethacin. In more severe cases of RA, with high levels of inflammation not easily controlled by these milder types of anti-inflammatory medications, "corticosteroid steroids" may be used short-term, to decrease inflammation levels. In cases of rapidly progressing RA, treatment can include the use of "gold compounds", which are injected directly into the joint, to slow joint deformity. D-penicillamine, anti-malarial drugs, and sulfasalazine might also be used in more severe cases of RA, to help reduce inflammation and antibody levels, as well as drugs that help reduce immune system activity which include; methotrexate, azathioprine, and cyclophosphamide. The drugs that suppress the immune system, called "immunosuppressive therapy" and corticosteroid steroids, are not administered in all cases of RA, due to the risk of possible side effects from these more powerful drugs. In milder cases of Rheumatoid Arthritis, rest and good nutrition may be all that is needed. While there is no cure for RA or even a treatment that keeps it from developing, symptom flare-ups and joint destruction/deformity can be reduced and slowed down, by following the prescribed treatment.
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