Rheumatic arthritis is a chronic long – lasting autoimmune disease which affects the joints. It can cause inflammation, swelling, and pain in or on the joint. RA can affect other parts of the body apart from joints such as the eyes, lungs, heart and blood vessels.

Rheumatic arthritis differs from osteoarthritis in that it affects the lining of the joints which will cause painful swelling that will later turn into bone erosion and joint deformity.

 Types of rheumatoid arthritis

There are three types of RA and they include:

• Seropositive rheumatoid arthritis: This is a condition in which there are high levels of antibodies called anti- cyclic citrullinated peptides (anti- CCP). It can take up to 10 years symptoms to occur from the high level of these antibodies. According to Arthritis Foundation about 60 – 80 % of people diagnosed of rheumatoid arthritis are in this category of seropositive RA.

• Seronegative rheumatoid arthritis: In this type of RA there is absence of antibodies in the blood found in seropositive RA. The absence of these antibodies makes it difficult to diagnose this type of rheumatoid arthritis.

• Juvenile rheumatoid arthritis: This is the type of arthritis that develops before the age of 16. Doctors calls it juvenile idiopathic arthritis

Symptoms of rheumatoid arthritis

The symptoms of RA are:

• Pain, swelling, and tenderness in more than one joint.
• Fatigue
• Weakness
•  Stiffness especially in the mornings or after sitting for a long time
• Fever
• Loss of appetite
• Weight loss
• Inability to walk or difficulty in walking

Other medical problems that rheumatoid arthritis can cause include

• Neck pain
• Anemia
• Mouth and eyes becomes dry
• Lung disease
• Inflammation of the lung tissue, airways and blood vessels
• Lumps that are found below the skin on the elbows and hands.

Causes of rheumatoid arthritis

Rheumatoid arthritis is caused by the malfunctioning of the immune system which makes it to attack the membrane lining (synovium) of the joints causing the synovial cells to proliferate and become thickened. The result will be inflammation and pain in the joint.

If it is not treated on time the inflammation can destroy the cartilage and cause the ligaments and tendons that hold the joints together to become weak and stretch. The joint can lose it shape and become severally damaged.

It is not yet known what can make the immune system to misbehave and start attacking the body system instead of protecting it from disease causing organisms.

Risk factors of rheumatoid arthritis

The following are factors that will make people to be at a greater risk of developing rheumatoid arthritis. These include:

• Age: People above 60 years are at greater risk of developing RA than those who are younger.
• Women: Women are at greater risk of developing RA than men. Also women who have not yet given birth are at greater risk of developing RA.
• Obesity: People who are  obsessed are at a higher risk of developing  RA than people who are  not
• Smokers: People who smoke have greater chances of developing rheumatoid arthritis.
• Genetic traits: Some genetic traits makes  people to be at a high risk of developing RA

Diagnosis of Rheumatoid Arthritis

Diagnosing RA at the early stage may be difficult for doctors because it can resemble other conditions and so the Centers for Disease Control and Prevention (CDC) recommend diagnosis to be done within 6 months of the onset of the symptoms to get treated on time.

The doctor will carry out a physical examination of the patient and check for signs of inflammation and swelling in the joints.

Blood test: Blood tests can be used to diagnose rheumatoid arthritis. The presence of elevated erythrocyte sedimentation rate (ESR) or C- reactive protein (CRP) level is often associated with people with rheumatoid arthritis. This can indicate that there is an inflammatory process in the body. Blood tests can also be used to anti-cyclic citrullinated peptide (anti- CCP) antibodies and rheumatoid factor.

Imaging tests: X-rays can be used to diagnose rheumatoid arthritis. It can also be used to track how the condition has been progressing over time. The doctor can also MRI and ultrasound test to check the severity of the rheumatoid condition.

Treatments for Rheumatoid Arthritis

A cure for rheumatoid arthritis is yet to be discovered. But if treatments begin early with medication known as disease-modifying antirheumatic drugs (DMARDs) there can be a relief from the symptoms.

The following are the types of medications that can be used to treat rheumatoid arthritis

• Steroids: Prednisone a corticosteroid medications can be used to slow the damage to joints, reduce pain and inflammation of the joint. It is very helpful for acute symptoms or short term flare –ups. These medications should not be used for too long because of its side effects which include bone thinning, weight gain and diabetes.
• NSAIDs: Non steroidal anti-inflammatory drugs (NSAIDs) can be used to relieve pain and inflammation. These drugs are available in pharmacies over the counter (OTC). Examples of NSAIDS include Motrin, Advil and Aleve. These drugs can cause side effects if they are used for a long time and if high doses are taken. The side effects can include:
• Gastric ulcers
• High blood pressure
• Liver and kidney damage

• DMARDs: Disease-Modifying antirheumatic drugs (DMARDs) are used to treat moderate to severe rheumatoid arthritis. They can stall the progress of RA and prevent permanent damage to the joints and other tissue in the body by interfering with the activities of a misbehaving immune system. Example of DMARDs is Methrotrexate (Rheumatrex or Trexall).

DMARDs can come with side effects such as:

• Liver damage
• Ulcers in the mouth
• Loss of hair
• Loose stool or nausea
• Disorder of the immune system.
• Abnormal blood counts.

• Biologics treatments: Biologic treatment such as Tumor Necrosis Factor – alpha (TNF-alpha) inhibitors can cause a change in how the immune system works when a person faces an infection. When the body faces a threat of an infection TNF-alpha will be produce. This TNF- alpha is an inflammatory substance which can lead to inflammation. The TNF- alpha inhibitors are to prevent this inflammatory substance so as to prevent inflammation.

The pains and stiffness of rheumatoid arthritis can be reduced by these TNF- alpha inhibitors. They can be used to treat swollen or tender joints of RA. Noticeable improvements can be seen after 2 weeks from the onset of these treatments.

Biologics treatments can come with some side effects such as:

• The risks getting  infections becomes higher
• Damage to the myelin sheath that protect nerve fibers.
• Lupus
• lymphoma

• Surgery: Surgery can be used to repair damaged joints, reduce pain and correct any deformity caused by the condition. This can be achieved through removing inflamed joint tissue (arthroscopic surgery) or freeing tendons that causes unusual bending of the fingers or total replacement of the joint.