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Rheumatoid Arthritis
Arthritis refers to inflammation and irritation within a joint. In rheumatoid arthritis (RA), inflammation stems from the abnormal response of the body's immune system, resulting in destruction of certain joints. Rheumatoid arthritis can be an inherited disease. It generally has a progressive course and, in
some cases, can be rapidly debilitating. Rheumatoid arthritis frequently affects patients after age 40. Some childhood forms of RA also exist.
Common symptoms include morning stiffness (which seems to improve through the day), joint swelling, and joint pain. Joints commonly affected are the knees, wrists, and small joints of the hands. Long term arthritis can lead to joint deformity and improper joint function. Patients may exhibit symptoms of Raynaud's disease, with pain and stiffness in the fingers, after exposure to cold. Other symptoms associated with rheumatic disease include pleurisy, eye pain or irritation (uveitis), and shortness of breath (secondary to a fluid accumulation in the chest cavity). Evaluation will include history and physical examination. Special blood tests pertaining to the immune system will be done to provide a serologic diagnosis for the disease (rheumatoid factor). X-rays of the involved joints can reveal the kind of changes associated with rheumatoid arthritis.
Treatment is long term and includes the use of various medications to suppress the body's immune response and to treat inflammation. Anti-inflammatory medications such as ibuprofen and (Prednisone) are often used. An immunosuppresive agent such as (Plaquenil) is used in more difficult to control cases. Rheumatoid arthritis has a pattern of remitting and exacerbating illness--often resulting in painful flare-ups. These attacks are characterized by multiple joint swelling and pain. Admission to the hospital to control the flare-up of arthritis is needed only rarely. Physical and occupational therapy play a key role in maintaining normal function in the patient with rheumatoid arthritis. The Rheumatologist is be the expert in the treatment of this problem. An Ophthalmologist may be necessary for the treatment of any problems involving the eyes.
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