Rheumatoid Arthritis

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 Rheumatoid arthritis is a chronic inflammatory disorder that can  affect more than just your joints. In some people, the condition can  damage a wide variety of body systems, including the skin, eyes, lungs,  heart and blood vessels.  

An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues.

Unlike the wear-and-tear damage of osteoarthritis, rheumatoid  arthritis affects the lining of your joints, causing a painful swelling  that can eventually result in bone erosion and joint deformity.

The inflammation associated with rheumatoid arthritis is what can  damage other parts of the body as well. While new types of medications  have improved treatment options dramatically, severe rheumatoid  arthritis can still cause physical disabilities.

Signs and symptoms of rheumatoid arthritis may include:

• Tender, warm, swollen joints
• Joint stiffness that is usually worse in the mornings and after inactivity
• Fatigue, fever and loss of appetite

Early rheumatoid arthritis tends to affect your smaller joints first —  particularly the joints that attach your fingers to your hands and your  toes to your feet.

As the disease progresses, symptoms often spread to the wrists,  knees, ankles, elbows, hips and shoulders. In most cases, symptoms occur  in the same joints on both sides of your body.

About 40 percent of the people who have rheumatoid arthritis also  experience signs and symptoms that don't involve the joints. Rheumatoid  arthritis can affect many nonjoint structures, including:

• Skin
• Eyes
• Lungs
• Heart
• Kidneys
• Salivary glands
• Nerve tissue
• Bone marrow
• Blood vessels

Rheumatoid arthritis signs and symptoms may vary in severity and may  even come and go. Periods of increased disease activity, called flares,  alternate with periods of relative remission — when the swelling and  pain fade or disappear. Over time, rheumatoid arthritis can cause joints  to deform and shift out of place.

Make an appointment with a doctor if you have persistent discomfort and swelling in your joints. 

Rheumatoid arthritis occurs when your immune system attacks the  synovium — the lining of the membranes that surround your joints.

The resulting inflammation thickens the synovium, which can eventually destroy the cartilage and bone within the joint.

The tendons and ligaments that hold the joint together weaken and stretch. Gradually, the joint loses its shape and alignment.

Doctors don't know what starts this process, although a genetic  component appears likely. While your genes don't actually cause  rheumatoid arthritis, they can make you more susceptible to  environmental factors — such as infection with certain viruses and  bacteria — that may trigger the disease.

Factors that may increase your risk of rheumatoid arthritis include:

• Your sex. Women are more likely than men to develop rheumatoid arthritis.
• Age. Rheumatoid arthritis can occur at any age, but it most commonly begins in middle age.
• Family history. If a member of your family has rheumatoid arthritis, you may have an increased risk of the disease.
• Smoking. Cigarette smoking increases your risk of  developing rheumatoid arthritis, particularly if you have a genetic  predisposition for developing the disease. Smoking also appears to be  associated with greater disease severity.
• Environmental exposures. Although poorly  understood, some exposures such as asbestos or silica may increase the  risk of developing rheumatoid arthritis. Emergency workers exposed to  dust from the collapse of the World Trade Center are at higher risk of  autoimmune diseases such as rheumatoid arthritis.
• Obesity. People — especially women age 55 and  younger — who are overweight or obese appear to be at a somewhat higher  risk of developing rheumatoid arthritis

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Rheumatoid arthritis increases your risk of developing:

• Osteoporosis. Rheumatoid arthritis itself, along  with some medications used for treating rheumatoid arthritis, can  increase your risk of osteoporosis — a condition that weakens your bones  and makes them more prone to fracture.
• Rheumatoid nodules. These firm bumps of tissue most  commonly form around pressure points, such as the elbows. However,  these nodules can form anywhere in the body, including the lungs.
• Dry eyes and mouth. People who have rheumatoid  arthritis are much more likely to experience Sjogren's syndrome, a  disorder that decreases the amount of moisture in your eyes and mouth.
• Infections. The disease itself and many of the  medications used to combat rheumatoid arthritis can impair the immune  system, leading to increased infections.
• Abnormal body composition. The proportion of fat to  lean mass is often higher in people who have rheumatoid arthritis, even  in people who have a normal body mass index (BMI).
• Carpal tunnel syndrome. If rheumatoid arthritis affects your wrists, the inflammation can compress the nerve that serves most of your hand and fingers.
• Heart problems. Rheumatoid arthritis can increase  your risk of hardened and blocked arteries, as well as inflammation of  the sac that encloses your heart.
• Lung disease. People with rheumatoid arthritis have  an increased risk of inflammation and scarring of the lung tissues,  which can lead to progressive shortness of breath.
• Lymphoma. Rheumatoid arthritis increases the risk of lymphoma, a group of blood cancers that develop in the lymph system.