What is rheumatoid arthritis?
- Rheumatoid arthritis (RA) is a long-term inflammatory disease that causes swelling, stiffness and pain in the joints
- RA usually affects small joints and generally occurs in symmetrical pattern i.e. affecting both left and right-hand side joints at the same time
- The most common joints that are affected by RA are the wrists and finger joints of the hand
- RA can also affect other joints including ankles, elbows, hips, knees, neck and shoulder
- Sharp pain and stiffness for over 30 minutes typically in the morning are characteristic signs of RA
- Symptoms of RA usually last for many years – often lifelong, with sudden episodes of flare or severe disease activity
- People suffering from RA often develop depression, anxiety and inability to perform daily activities of life
What causes rheumatoid arthritis?
Rheumatoid arthritis is an autoimmune disorder, which means the person’s immune system attacks normal joint tissue due to functional error,
causing swelling and pain. The exact cause of this autoimmune disorder is not known, however, clinical research studies have shown that few
factors increase the risk of developing RA
- Genetic factor – Genes are inherited from the parents and scientists have found out certain genes that are linked to development of RA, however,
every individual having these genes might not develop RA. Hence, although a person’s genetic makeup can play an important role in malfunctioning of
immune system, it is not the only factor that is responsible for RA
- Environmental factor – No specific agent in nature has been discovered that could trigger the autoimmune reaction in RA
- Hormonal factor – It is observed that women are more likely to develop RA than men, thus suggesting a probable link of certain hormones that maybe
involved in RA progression. Pregnancy, breastfeeding and the use of contraceptive may adversely affect disease progression. Consult the doctor in case
you are pregnant, breastfeeding or using contraceptives for proper advice
What are the symptoms of rheumatoid arthritis?
- RA usually affects small joints causing swelling, stiffness and pain
- There is a progressive joint deterioration that begins with the wrists and fingers and gradually moves on to elbows, ankles, feet and the toes
- Other signs of disease include fatigues, tiredness and depression
- People might develop lumps under the skin called nodules, specially at the elbows
- Tingling or numbness in arms or legs
- Loss of appetite and weight loss
- People with RA also develop anemia i.e. decrease in the count of RBC
How is rheumatoid arthritis diagnosed?
Due to its variety of symptoms from person to person and similar features with other joint disorders, early diagnosis of RA is difficult. The doctor uses a number of tests, depending upon the range of symptoms to establish RA.
- Doctor will check for family history of RA and perform physical examination of the joints and muscle reflex, including person’s ability to move, bend and perform other daily activities
- Erythrocyte Sedimentation Rate (ESR) and C - reactive protein (CRP) level to detect inflammation
- Doctor use blood tests to confirm diagnosis of RA – laboratory tests include Rheumatoid Factor (RF), Anti-CCP antibody
- Imaging techniques like MRI and ultrasound are important to establish early stage of RA
- X-ray is used to determine the degree of joint destruction or deformity especially in later stages of RA
When to consult a rheumatologist?
Watch out for the below symptoms that can potentially lead to RA development
- Feeling of tenderness and warmth in the joints
- Swelling, stiffness and pain particularly in small joints affecting both the left and right hand for long duration
- Difficulty in performing daily activity of life due to joint pain
- If the person is tested positive for any of the above blood tests, refer to a rheumatologist for proper evaluation and diagnosis.
What is ankylosing spondylitis?
- Ankylosing spondylitis (AS) is inflammation of the spine joints and usually affects the lower back region
- Chronic inflammation of the spine leads to fusion of the vertebrae causing permanent stiffness and a hunched-forward posture
- Most common joints affected by AS are the joints of the neck, back and pelvis
- AS can sometimes develop into serious eye complication
What causes ankylosing spondylitis?
The exact cause of ankylosing spondylitis is not clear, however, there is as strong genetic link related to the development of AS.
In particular people with a gene called HLA-B27 are at greater risk of developing ankylosing spondylitis. However, many people with
this gene do not develop AS.
What are the symptoms of ankylosing spondylitis?
- Low back pain, and pain over the buttocks moving down the back of the thighs are the most common symptom of AS
- Pain is also experienced in the chest due to inflammation of rib joint
- Other joints affected are the back of the heel and feet
- Morning stiffness and pain that lasting for over 30 minutes that usually worsens with rest, but improves with exercise
- Inflammation of the eye called uveitis
How is ankylosing spondylitis diagnosed?
- Familial history of inflammation of low back pain
- Physical examination of the symptoms of decreased range of motion in spine
- X-ray and or MRI images of the spine joints to confirm fusing of the vertebrae