Rheumatoid Arthritis

It is an autoimmune disease that affects joints.The immune system of our body protect us from the attack of various organisms and foreign bodies but in Rheumatoid arthritis it starts attacking the lining of joints. It is a chronic inflammatory disease which affects the joints. No specific cause known yet but scientific evidence shows the involvement of various factors like-genes, hormones and environmental factors .

American Rheumatism Association(ARA) Diagnostic Criteria for RA

- RA criteria: (if 5 out of following are present for > 6 weeks);

    - morning stiffness;

    - pain on motion, or tenderness in at least one joint;
   - swelling (soft tissue thickening or fluid, not bony overgrowth           alone) in at least one joint;
   - swelling of at least one other joint (any interval free of                      joint symptoms between the two joint);
    - poor mucin precipitate from synovial fluid
    - characteristic histologic changes in synovium

    - characteristic histologic changes in nodules

- Exclusion Criteria:
    - rash of systemic lupus erythematosus
    - high concentration of LE cells, or other clear-cut evidence of lupus
    - histologic evidence of periarteritis nodosa
    - clinical features of dermatomyositis, scleroderma;
    - acute rheumatic fever;

    - gouty arthritis

    - infectious arthritis

    - Reiter's syndrome

    - shoulder-hand syndrome

    - hypertrophic osteoarthropathy

    - neuroarthropathy

    - alkaptonuria

    - sarcoidosis

    - multiple myeloma

    - erythema nodosum

    - leukemia, lymphoma, or agammaglobulinemia

 Symptoms

-Joint –pain,swelling , tenderness ,warmth. Stiffness  in the joint especially early morning.

-Small joints involvement  like wrist, hand,feet etc. As the disease progresses  other joints like hip ,knee,shoulder and elbows can also get affected.

-Fatigue and weight loss.

Other  organs and body systems affected are:

·         Blood vessels

·         Mouth

·         Eyes

·         Skin

·         Lungs

·         Salivary glands

·         Heart

Symptoms of Rheumatoid arthritis are never constant. They can persists for sometime and then disappear or reappear after sometime .A flare (periods of high disease activity) can lasts for few days \months. The symptoms can come and go.

By: Pooja Dhamija PT