What is Rheumatoid Arthritis?
Rheumatoid arthritis (RA) is a chronic autoimmune disease in which the immune system attacks the lining of joints (the synovium), causing inflammation, pain, swelling, and eventually joint damage. Unlike osteoarthritis, which results from wear and tear, RA is an inflammatory condition driven by the immune system. It can affect people of all ages, including children, but most commonly develops between the ages of 40 and 60. Women are two to three times more likely to develop RA than men.
What Causes it?
The exact cause of RA is unknown, but it involves a combination of genetic susceptibility and environmental triggers. Smoking is the strongest known environmental risk factor. Other possible triggers include infections, hormonal changes, and physical or emotional stress.
Symptoms
- Joint pain, swelling, and tenderness — especially in the small joints of the hands and feet
- Morning stiffness lasting more than 30 minutes
- Symmetrical joint involvement (both sides of the body affected)
- Fatigue and general feeling of being unwell
- Low-grade fever
- Rheumatoid nodules (firm bumps under the skin)
- In severe cases, complications affecting the eyes, heart, and lungs
Diagnosis
Diagnosis involves blood tests (including for rheumatoid factor and anti-CCP antibodies), imaging (X-rays, ultrasound, MRI), and a physical examination. Early diagnosis is crucial as prompt treatment can prevent joint damage.
Treatment
RA is treated with disease-modifying antirheumatic drugs (DMARDs), which slow disease progression and prevent joint damage. Methotrexate is usually the first DMARD prescribed. Biologics (such as adalimumab) are used for moderate to severe RA that does not respond to conventional DMARDs. NSAIDs and corticosteroids are used to manage inflammation and pain.