Rheumatoid Arthritis: Symptoms, Diagnosis, and Treatment

Rheumatoid Arthritis (RA) is a complex and debilitating autoimmune disease that affects millions of people worldwide. The main characteristic of rheumatoid arthritis is the body’s immune system accidentally attacking healthy cells, leading to inflammation (painful swelling) in the areas of the body affected. This chronic inflammatory condition can result in severe joint damage, pain, and decreased quality of life for those who suffer from it. Hand, wrist, and knee joints are often affected by RA. Chronic or long-lasting discomfort, instability (loss of balance), and deformity can all result from this tissue injury.

In addition to these tissues, RA can harm other organs, including the heart, lungs, and eyes as well as other tissues all over the body. While there is no known cure for rheumatoid arthritis, early diagnosis and effective treatment can significantly improve the lives of affected individuals.

Symptoms of Rheumatoid Arthritis

Rheumatoid arthritis can manifest with a wide range of symptoms, varying from person to person. Recognising these symptoms early is important to facilitate prompt diagnosis and treatment. Here are some common symptoms of rheumatoid arthritis:

• Joint Pain and Stiffness – One of the earliest and most prominent symptoms of RA is joint pain and stiffness, which is often worse in the morning or after periods of inactivity. This pain usually affects the small joints of the hands, feet, and wrists but can occur in any joint, including the knees, hips, and shoulders.
• Swelling and Redness – Affected joints can become swollen, tender, and warm to the touch. The inflammation can cause noticeable redness and a sensation of heat around the affected area.
• Symmetrical Joint Involvement – RA typically affects joints on both sides of the body. If the right knee is affected, the left knee is likely to be affected as well. This symmetrical pattern is a key feature that helps distinguish RA from other forms of arthritis.
• Fatigue – RA often leads to chronic fatigue, making daily activities more challenging for those affected. This fatigue is a result of the body’s ongoing immune response and the inflammatory process.
• Decreased Range of Motion – Over time, joint damage can lead to a decreased range of motion in affected joints. This can limit a person’s ability to perform everyday tasks.
• Fever and Weight Loss – Some individuals with RA may experience fever and unexplained weight loss as a result of the systemic inflammation and immune response.
• Nodules – In some cases, small, firm bumps called rheumatoid nodules may develop under the skin, usually near joints. They can range in size from pea-sized to golf ball-sized.
• Eye and Lung Involvement – RA can affect other organs, including the eyes and lungs. Dry eyes, inflammation of the eye’s white part (scleritis), and inflammation of the lung lining are among the potential complications.

It’s essential to note that RA is a chronic condition, and its symptoms can fluctuate over time, with periods of remission and flare-ups. Identifying these symptoms and monitoring their progression is crucial for early diagnosis and effective management.

Diagnostic Procedure for Rheumatoids Arthritis

To identify the existence of rheumatoid arthritis, a rheumatologist—often a medical specialist conducts comprehensive medical tests. The diagnostic process includes the following steps: Medical History First, a doctor will obtain a thorough medical history. They will inquire about symptoms, their duration, and any pertinent autoimmune conditions or a family history of arthritis. Physical Examination A comprehensive physical examination will be conducted to assess joint swelling, redness, and mobility. The doctor will also look for signs of rheumatoid nodules or other extra-articular manifestations. Blood Tests Blood tests are an essential component of RA diagnosis. The most common blood tests for rheumatoid arthritis include:

• Rheumatoid Factor (RF): This blood test looks for the antibody known as RF, which many patients with rheumatoid arthritis may have in their system. Not all individuals with RA test positive for RF; other individuals test positive but never develop the disease; and some individuals test positive but have another illness. Doctors can identify rheumatoid arthritis using the findings of this test in combination with those from other tests.
• Anti-Cyclic Citrullinated Peptide (anti-CCP) Antibodies: This blood test looks for anti-CCP antibodies, which are frequently seen in rheumatoid arthritis patients. Anti-CCP may also manifest prior to the onset of RA symptoms, aiding in an early diagnosis by medical professionals.  
• C-reactive Protein (CRP) and Erythrocyte Sedimentation Rate (ESR): This is an ordinary screening for inflammation that may be used to identify rheumatoid arthritis and track the progression of the condition and its response to therapy.
• Erythrocyte sedimentation rate: By measuring inflammation in the body, this test keeps track of disease activity and how well treatments are working.

Imaging X-rays and other imaging studies such as ultrasound and magnetic resonance imaging (MRI) can help visualise joint damage and detect erosions or swelling. Synovial Fluid Analysis In some cases, a synovial fluid analysis may be performed. A sample of the synovial fluid is taken from an affected joint and analysed for signs of inflammation or the presence of certain cells and proteins associated with RA. A diagnosis of rheumatoid arthritis is made when a combination of clinical findings, blood test results, and imaging studies support the presence of the disease. Early diagnosis is crucial because it enables healthcare providers to initiate treatment promptly, preventing or minimising joint damage and complications.

Treatment Methods for Rheumatoid Arthritis

While there is no cure for rheumatoid arthritis, there are several treatment options available to help manage the condition and improve the quality of life for those affected. The treatment plan is typically tailored to the individual and may involve a combination of the following approaches:

1. Medications 

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): These drugs help relieve pain and reduce inflammation.
• Disease-Modifying Antirheumatic Drugs (DMARDs): DMARDs slow down the progression of RA by suppressing the immune system’s abnormal response.
• Biologic Agents: These medications target certain immune signals and inhibit the signal if the disease does not respond to initial therapy. This aids in reducing or stopping inflammation.
• Corticosteroids: Steroids may be used to reduce inflammation in the short term, but their long-term use is generally avoided due to side effects.
• Janus kinase (JAK) inhibitors: Janus kinase (JAK) inhibitors, which are also DMARDs, transmit instructions to certain cells in order to reduce inflammation from the inside. If the illness does not improve after trying several treatments, these drugs could also be tried.

2. Physical Therapy: Physical therapy can help improve joint function, reduce pain, and enhance overall mobility.

3. Occupational Therapy: Occupational therapists can assist individuals in discovering practical ways to manage everyday tasks and minimise strain on affected joints.

4. Lifestyle Modifications: Maintaining a healthy lifestyle with a balanced diet, regular exercise, and stress management can help improve the overall well-being of RA patients.

5. Surgery: In cases of severe joint damage, surgical procedures such as joint replacement may be considered to restore function and alleviate pain.

6. Supportive Therapies: In addition to conventional treatment, complementary therapies, such as acupuncture, massage, and dietary supplements may be explored, but their effectiveness varies from person to person.

Conclusion

Rheumatoid arthritis is a complex autoimmune disease that affects many aspects of a person’s life. Early diagnosis and appropriate treatment can significantly improve the quality of life for those living with this condition. Omni Hospital stands out as a leading institution for rheumatoid arthritis treatment, thanks to its specialised care, advanced diagnostic capabilities, comprehensive treatment options, and a patient-centred approach. By choosing the right healthcare provider and collaborating closely with their medical team, individuals with rheumatoid arthritis can better manage their symptoms and lead fulfilling lives despite the challenges posed by the disease.