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Understanding Rheumatoid Arthritis

Rheumatoid Arthritis
What is Rheumatoid Arthritis?
Rheumatoid Arthritis is an autoimmune disease affecting the joints.
What do you mean by an autoimmune disease?
Normally, body’s immune system is designed to fight microoraganisms causing infections. Due to various reasons, the immune system may start considering its own body organs as foreign and attacks it. This self intolerance is known as autoimmunity. The condition it results into is called as autoimmune disease.
What causes joint swelling in Rheumatoid Arthritis?
To understand the cause of joint swelling in Rheumatoid Arthritis, let us first understand the structure of a synovial joint. A joint is made up of two bones. It is lined on the inner side by a protective lining called the synovium. This synovium is the target of immune attack & gets swollen. To begin with the swelling is mild. Hence it is not very obvious from outside. HOwever, it does cause pain & stiffness of the joint. Later, as the swelling increases, it becomes clearly visible externally as well.

Normal Joint

Joint with Rheumatoid arthritis. Note the swollen synovium that has started eroding the cartilege & the underlying bone.

What causes deformities in Rheumatoid Arthritis?
The swollen synovium in Rheumatoid Arthritis has destructive potential. If not teated, it begins damaging the underlying bones. This damage involving the bones and surrounding muscles leads to deformities.

Deformities in long standing and Untreated Rheumatoid Arthritis

If untreated, the inflamed swollen synovium destroys the underlying cartilage & eventually the bone. This ultimately leads to deformities. It is important to note that deformities are most commonly seen in long standing & untreated rheumatoid arthritis.

Rheumatoid Arthritis Destruction Of Bones X-Ray

X ray revealing the destruction of bones (known as bony erosions) caused by rheumatoid arthritis. The bony destruction leads to deformities & limitation of function apart from the pain due to active disease.

Can these deformities be prevented?
Yes, If rheumatoid arthritis is treated early and with Disease modifying agents like methotrexate, leflunomide, hydroxychloroquine, infliximab or etanercept, deformities can be prevented.
What are the symptoms of Rheumatoid Arthritis?
Rheumatoid arthritis commonly affects the joints of the hands (knuckles and the first joint of the fingers). It also affects the small joints of the feet. The wrist, elbow, shoulder, knee and ankle can also be affected.
Initially, a person may not experience obvious swelling in the said joints. However, there is pain & stiffness of these joints early in the morning. The stiffness settles after a hot water bath or as the joints are used. Later, as the arthritis progresses, the swelling becomes obvious.

Rheumatoid Arthritis Swelling Of Hand Joints

Note the swelling of the hand joints seen in early rheumatoid arthritis.

The underlying synovial swelling that causes the hand joint swelling in Rheumatoid Arthritis.

Rheumatoid Arthrits Swollen Knee

Swollen Knee due to Rheumatoid Arthritis

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Also Read:
How to arrange your kitchen if you have arthritis?
How to plan a house cleaning job if you have arthritis.
Carpal Tunnel syndrome
Anti CCP antibody in diagnosis of Rheumatoid arthritis.
Palindromic rheumatism
Rheumatoid factor
Rheumatoid nodule
Created on: April 2007
Last updated on: Feb 2015
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