What is Rheumatoid Arthritis?
Rheumatoid arthritis is one of the most common forms of arthritis in the hand, along with osteoarthritis. While osteoarthritis occurs through wear and tear, rheumatoid arthritis is an autoimmune disease. This type of disease occurs when the body falsely identifies a naturally occurring protein within the body as being foreign, and attempts to get rid of it. In the case of rheumatoid arthritis, the body targets a protein within the synovial lining of a joint. This lining secretes fluid that is essential to lubricate and cushion the joint. When the synovial lining is injured, it can allow inflammatory cells into the joint and bone. These wear away at the cartilage and bone. Rheumatoid arthritis can affect any joint, and can occur in any age group.
Rheumatoid arthritis is thought to be caused in part by genetics. Researchers haven’t yet determined what genes are influential in the passing on of this disease. Another probable factor is the existence of certain outside conditions that trigger an immune response that “turns on” the arthritis. Hormones may also play a role, as 70% of those affected are women.
How is Rheumatoid Arthritis Diagnosed?
Your physician will first go over your medical history, and possibly the medical history of your immediate family. This should be followed by questions about your symptoms (when they started, how they have progressed, etc), what sort of treatment you’ve had, and other relevant information. You will then be given a physical exam. Stressing the affected joints should cause slight discomfort, which will confirm the location of the problem. The physician will also look for other signs, such as swelling and limited motion in the joints, as well as lumps or nodules under the skin.
After the examination, you may be sent to get diagnostic tests done, such as x-rays and blood tests. X-rays can check for bone damage and cartilage loss, while blood tests are done to look for levels of antibodies and inflammation known to be present with rheumatoid arthritis, along with proteins called rheumatoid factor. These are present in 80% of people with rheumatoid arthritis. They target and attack healthy tissue in the body. The physician may also take a fluid sample to rule out other conditions such as gout or lupus that can cause some of the same symptoms.
How is Rheumatoid Arthritis Treated?
Current treatments for rheumatoid arthritis aim to treat symptoms such as swelling and pain, and allow the joints to function properly again. There is no known cure for rheumatoid arthritis at the present time.
There are both surgical and non-surgical treatments for rheumatoid arthritis. Non-surgical treatments may be better for when the disease has not yet begun to progress, while surgical treatments can help after the arthritis has taken a toll on the joints.
Cases that are mild and stable can be treated with painkillers and anti-inflammatory drugs, such as ibuprofen. Current research suggests that the disease is best treated immediately after its development, before problems such as erosion can occur. This treatment uses disease modifying drugs, such as methotrexate. Steroid injections into the joint or tendon can also be very helpful. Another alternative is splinting. While this will not stop deformity and erosion, it can help ease pain and increase function.
Surgery can be extremely helpful for people with rheumatoid arthritis. For smaller joints within the hand and wrist, you might consider fusion (joining the bones of the joint together). For larger joints, such as hips and knees, replacement is usually a better option. Inflamed tendons may also require surgical treatment to keep from rupturing. If the tendon has already ruptured, there are several treatments that can replace the tendon or bridge the gap left behind.
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