Rheumatoid arthritis (RA) is a systemic disease that affects the entire body and is one of the most common forms of arthritis. It is characterized by the inflammation of the membrane lining the joint, which causes pain, stiffness, warmth, redness and swelling. The inflamed joint lining, the synovium, can invade and damage bone and cartilage. Inflammatory cells release enzymes that may digest bone and cartilage. The involved joint can lose its shape and alignment, resulting in pain and loss of movement. The disease usually begins in middle age, but can start at any age. It affects two to three times more women than men.
The cause of rheumatoid arthritis is not yet known. However, it is known that RA is an autoimmune disease. The body's natural immune system does not operate as it should, resulting in the immune system attacking healthy joint tissue and causing inflammation and subsequent joint damage.
Researchers suspect that agent-like viruses may trigger RA in some people who have an inherited tendency for the disease. Many people with RA have a certain genetic marker called HLA-DR4. Researchers know that there are other genes that influence the development of RA.
It is important to diagnose RA early in the course of the disease because with the use of disease-modifying drugs, the condition can be controlled in many cases. Physicians diagnose RA based on the overall pattern of symptoms, medical history, physical exam and lab tests including a test for rheumatoid factor. Rheumatoid factor is an antibody found in the blood of about 80 percent of adults with RA. However, the presence or absence of rheumatoid factor does not indicate that one has RA.
Early in the disease, people may notice general fatigue, soreness, stiffness and aching. Pain and swelling may occur in the same joints on both sides of the body and will usually start in the hands or feet. RA can also affect wrists, elbows, shoulders, neck, knees, hips and ankles. Other features include lumps called rheumatoid nodules under the skin in areas that receive pressure, such as the back of the elbows.
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