Rheumatoid Arthritis Overview

A period of time before the onset of symptoms, where the person may not experience any noticeable signs of the disease.

A sudden worsening of symptoms, often involving a specific joint or joints.

A chronic inflammatory disease that primarily affects the joints, causing pain, swelling, and stiffness.

A laboratory test that detects the presence of antibodies, indicating a higher risk of developing RA.

Blood tests that measure inflammation in the body, higher levels are associated with a higher risk of progressing to RA.

An inflammatory condition that affects muscles and joints, particularly in the shoulders and hips, often in older adults.

Inflammation of the synovial membrane, the lining of the joints.

The upper part of the spine, comprising the first seven vertebrae.

A condition where the bones of the spine become misaligned, often occurring in the neck.

A type of arthritis that primarily affects cartilage, leading to joint pain and stiffness.

A chronic, systemic, inflammatory disorder of joints characterized by symmetrical joint involvement, and antibody elevation, often including rheumatoid factor (RF) and antibodies to citrullinated protein/peptide antigens (ACPA).

The primary site of RA pathology is the synovium, the lining of the joints. This tissue becomes inflamed and proliferates, forming pannus, which invades bone, cartilage, and ligaments, resulting in joint damage and deformities.

The exact cause of RA is unknown, but genetics and environment play a role. Strongest genetic association is with variants in the HLA region. Environmental factors include smoking, bacteria, and viruses.

RA affects all races, but Native Americans have a higher prevalence. Females are more likely than males to develop RA (2-3 times more) with an average onset age between 40-60 for women and older for men. Approximately 1% of adults develop RA.

Autoantibodies, including rheumatoid factor (RF) and antibodies to modified protein antigens (AMPAs) like citrullinated and carbamylated proteins, play a role in RA pathogenesis. These antibodies attack the body's own tissues.

The onset of RA can be insidious (slow and gradual), subacute (more systemic symptoms), or acute (rapid and severe). Some people experience a palindromic pattern, with episodes that resolve within days and involve fewer joints.

The presence of rheumatoid factor (RF) and antibodies to citrullinated protein/peptide antigens (ACPA) in blood serum strongly suggests RA.

Tissue inflammation in RA can increase vascular permeability, allowing more inflammatory cells and antibodies to enter the joint, further intensifying the inflammatory process.

It is hypothesized that ACPAs target citrullinated proteins in the joint, and immune complexes can deposit in synovial venules, triggering inflammation via complement activation.

Symptoms of RA can improve during pregnancy due to hormonal changes.

Drugs that slow or prevent joint damage in Rheumatoid Arthritis (RA). They're used when NSAIDs and corticosteroids aren't enough.

A type of DMARD that's been a cornerstone for RA treatment, often used as a first-line option. It can reduce disease activity and improve symptoms.

An abnormal alignment of joints, often seen in RA. This can include deformities like swan neck, ulnar deviation, and boutonnière.

A group of DMARDs that target specific parts of the immune system to reduce inflammation and joint damage. They work differently than conventional DMARDs and offer another powerful option.

A type of bDMARD that works by blocking the action of TNF-alpha, a protein that plays a key role in RA inflammation.

The presence of bone loss around joints, a common feature in RA.

This refers to uniform joint space loss, especially in weight-bearing joints, a hallmark of RA. It indicates cartilage deterioration.

A type of DMARD that is a targeted synthetic drug that works by inhibiting the JAK enzymes, which play a role in inflammation.

A surgical procedure that removes the inflamed lining of a joint to relieve pain and improve function in RA.

These are characteristic deformities of the fingers seen in RA, including swan neck, ulnar deviation, and boutonnière.

A common complication in RA patients, affecting them at a rate 1.5 to 2 times higher than the general population.

Small erosions at the edges of joints, often a sign of significant joint damage in RA.

This refers to swelling around joints, a common symptom in RA. It can be caused by inflammation and fluid buildup.

An increased risk in RA patients, with pneumonia being particularly prevalent.

A treatment strategy aimed at achieving low disease activity or remission in RA. It focuses on reducing inflammation and preventing joint damage.

A type of DMARD that works by targeting the immune system, but is not a biologic. For example, Leflunomide, Sulfasalazine, and Hydroxychloroquine.

This refers to the presence of nodules, or lumps, under the skin, often seen in patients with RA. They can be a sign of more severe disease.

This refers to the presence of inflammation in blood vessels, a complication that can occur in RA.