Rheumatoid arthritis (1)

It is an autoimmune chronic disorder that can affect joints of knees, wrists and hands. Moreover, it also targets nerves, blood, heart, lungs, eyes and skin.

Causes of rheumatoid arthritis

An unknown factor triggers the immune system of the body which in response attacks body cells. The body’s immune system produces antibodies. These hit the cells of the lining (synovium) that surrounds the joints. Degeneration of synovium releases certain chemicals that target nearby cartilage, tendons, ligaments and bones. Gradually joint loses its alignment and shape if rheumatoid arthritis is left untreated. There are several theories regarding this autoimmune attack but none of them has been proven.

Possible risk factors of rheumatoid arthritis

Several risk factors exist that may enhance the chances of having rheumatoid arthritis. Such as

  1. Due to certain effects of estrogen, women are more prone to rheumatoid arthritis than men.
  2. Several pieces of evidence have shown that genes play an important role in transferring this disorder. It means rheumatoid arthritis is inheritable.
  3. Some of the chemicals in cigarettes affect joints and make them weaker. It makes a person more vulnerable to rheumatoid arthritis.

Signs and symptoms of rheumatoid arthritis (2)

Joints are the main site of the target. Although rheumatoid arthritis can target any joint but small joints of the feet and hand are chiefly affected by it. More often it hits both sides of the body but there may be a different case as well.

  1. Pain

A patient with rheumatoid arthritis faces aching and throbbing pain in joints. This pain becomes worst after a span of inactivity and in the morning.

  1. Stiffness

A patient feels stiffness in the area of affected joints. For instance, if the site of a target is the hand then a patient cannot form a fist or bend fingers properly. Just like the case of joint pain, stiffness also gets worst in the morning. The difference between rheumatoid arthritis and osteoarthritis stiffness is that later one lasts up to 30 minutes only but the former takes a longer time.

  1. Redness, heat, and swelling

The degenerated synovium gets inflamed which makes the joint tender, swollen and hot to touch. About one-fourth of people suffering from rheumatoid arthritis also develop rheumatoid nodules. These firm lumps develop beneath the skin near the targeted joint. In some patients, these nodules disappear without any treatment but in some, they get larger over time.

Other general symptoms

  1. Lack of energy
  2. Tiredness
  3. Poor appetite
  4. More sweating
  5. Abrupt weight loss
  6. Dry eyes
  7. Chest pain

Complications of rheumatoid arthritis

A person with rheumatoid arthritis is at higher risk of getting other complications.

  1. Carpal tunnel syndrome

It is a very common complication a person with rheumatoid arthritis develops. In this complication, a nerve that controls movement and sensation in the hand get compressed and exhibits symptoms such as

  • Numbness
  • Aching
  • Tingling in fingers, thumb and parts of the hand
  1. Widespread inflammation

The rheumatic inflammatory condition causes inflammation to some other parts of the body as well.

  • Heart- swollen tissues around the heart cause pericarditis thus initiate heart pain.
  • Lungs- inflammation of tissues surrounding lungs causes pulmonary fibrosis or pleurisy, which can lead to persistent cough, chest pain and shortness of breath.
  • Blood vessels- vasculitis is the inflammation of blood vessels that causes scarring, narrowing, weakening, and thickening of blood vessels. In more severe cases, it obstructs the blood flow to the different parts of the body.
  • Eyes- scleritis is the condition in which eyes get inflamed. It causes dryness, redness and pain in the eyes.


It is difficult to diagnose rheumatoid arthritis because there are many other underlying causes of swollen and painful joints and there is no specific diagnostic test for the condition. However, there are certain measures to make a differential diagnosis.

  1. Physical examination

In this examination, a general physician checks the physical condition of joints. He determines the severity of swelling and pain of the joint by asking different questions from the patient.

  1. Blood tests

A blood test cannot exactly exhibit the existence of rheumatoid arthritis but shows certain indications of it. Such as

  • Erythrocyte sedimentation rate (ESR)- tells about the inflammation level in the body
  • C-reactive protein (CRP) – another test that assesses the severity of inflammation.
  • Complete blood count (CBC)- it rules out other possible underlying causes of the signs and symptoms. It also determines whether the patient is anemic or not because anemia is more common in patients of rheumatoid arthritis, although it is not the exact indicator of the condition.
  1. Rheumatoid factors

One blood test checks the presence of rheumatoid factors, which are proteins, produces by the immune system to attack body tissues. These proteins level are seen higher in the blood at the onset of disease.

  1. Joint scans

Scans are done to check for any joint damage or inflammation. It also differentiates the types of arthritis and tells the progression of disease with time. Two different scans are done to check rheumatoid arthritis.

  • MRI
  • X-ray


Treatment of rheumatoid arthritis does not eradicate it but reduces symptoms. It relieves the patient from pain, reduces inflammation, slows down or prevents joint damage, and enables him to work more effectively.

  1. Disease-modifying anti-rheumatic drugs (DMARDs)

These drugs are considered the first line of treatment. They slow down the progression of the condition. It inhibits the effect of certain chemicals released during the immune attack. Some of the DMARDs are:

  • Hydroxychloroquine
  • Methotrexate
  • Sulfasalazine
  1. Biological treatment

It is an advance treatment that includes infliximab and etanercept. They are given as combination therapy with DMARDs to relieve pain. These drugs are given intravenously.

  1. JAK inhibitors

This new type of medicine is given to patients who do not show response to DMARDs or biologicals. These inhibitors include baricitinib and tofacitinib.


  1. https://www.healthline.com/health/rheumatoid-arthritis#symptoms
  2. https://www.nhs.uk/conditions/rheumatoid-arthritis/treatment/