Rheumatoid Arthritis (RA)

Symptoms of RA often develop slowly over weeks or months. Fatigue and stiffness are usually early symptoms.

Joint symptoms include:

• Pain, stiffness, and swelling in the joints of the hands, wrists, elbows, feet, ankles, knees, or neck. The disease usually affects both sides of the body at the same time.
• Morning stiffness. Joint stiffness may develop after long periods of sleeping or sitting. It usually lasts at least 1 hour and often up to several hours.
• Bumps (nodules). Rheumatoid nodules ranging in size from a pea to a mothball form in nearly one-third of people who have RA. Nodules usually form over pressure points in the body such as the elbows, knuckles, spine, and lower leg bones.

Rheumatoid arthritis can also cause symptoms throughout the body (systemic). These include:

• Fatigue.
• A loss of appetite.
• Weight loss.
• Mild fever.

The cause of RA isn't fully understood. But it's an autoimmune disease. This means that the body's natural defense system attacks the joints.

Genes play a role, but experts don't know exactly what that role is. For most people with RA, the disease doesn't run in their families and they don't pass it along to their children. One or more genes may make it more likely that the body's immune system will attack the tissues of the joints. This immune response may also be triggered by bacteria, a virus, or some other foreign substance.

No single lab test can diagnose RA. The doctor will ask you questions about your health and look at your joints for signs of swelling or tenderness. The pattern and nature of joint symptoms are the most important clues to the diagnosis. Your doctor will then rule out other diseases that can cause similar symptoms.

Diagnosis is based on a set of classification criteria. The criteria include the results of these blood tests:

• Anti-cyclic citrullinated peptide antibody (ACPA or anti-CCP) test. It helps confirm the diagnosis and may show your risk of having severe symptoms.
• C-reactive protein. This test may help show how the disease is affecting you.
• Erythrocyte sedimentation rate. It may also help show how the disease is affecting you.
• Rheumatoid factor. This blood test measures the amount of the RF antibody in the blood.

RA is most often treated with medicine. Some medicines help to control the symptoms. Other medicines, especially when used early, can help to prevent the disease from getting worse.

Many of the medicines used to treat rheumatoid arthritis have side effects. Have regular checkups. And talk with your doctor about any problems. This will help your doctor find a treatment that works for you.

Physical therapy and finding the best balance between rest and activity can also help your symptoms.

If your treatment doesn't help, surgery may be an option. The type of surgery you can have depends on which joints are causing problems. Sometimes surgery to replace a joint (such as a hip or knee) is an option. Other types of surgery can remove debris or inflamed tissue from a joint, or relieve pressure on nerves.