Rheumatoid arthritis usually has symmetrical effects on the joints of the hands, feet, wrists, elbows, knees and ankles. It can also affect other body systems. Hence, it is called a systemic disease. In women, rheumatoid arthritis most commonly begins between ages 30 and 60. In men, it often occurs later in life.

Rheumatoid arthritis occurs when a person’s immune system mistakes the body’s healthy tissues for foreign invaders. As the immune system responds, inflammation occurs in the target tissue or organ. 

Synovium is the tissue that lines the inside of joints. It makes a fluid that lubricates joints and helps them move smoothly. Rheumatoid arthritis causes this tissue to thicken, resulting in swelling and pain in and around the joints. The tendons and ligaments that hold the joint together can also weaken and stretch. The joint eventually loses its shape and configuration. 

The joint damage that rheumatoid arthritis causes usually happens on both sides of the body.  This distinguishes it from other forms of arthritis, such as osteoarthritis. Rheumatoid arthritis that begins in people under 16 years of age is referred to as juvenile idiopathic arthritis.

Symptoms 

Rheumatoid arthritis symptoms can vary from mild to severe. It is a long-term disease marked by inflammation and pain in the joints. These symptoms occur during periods known as flares or exacerbations. Other times are known as periods of remission when symptoms stop completely. 

Along with pain, many people experience fatigue, loss of appetite and a low-grade fever. Inflammation of blood vessels can lead to damage in the nerves, skin and other organs.

Causes

The cause of rheumatoid arthritis is unknown. It is believed that the tendency to develop rheumatoid arthritis may be genetically inherited. 

It is also suspected that certain infections or factors in the environment might trigger the activation of the immune system in susceptible individuals. These factors include infectious agents such as bacteria or viruses and exposure to cigarette smoke, air pollution, insecticides and occupational exposures to mineral oil and silica.

 Regardless of the exact trigger, the Immune cells, called lymphocytes, are activated.

Diagnosis

Medical History: Personal and family medical history as well as recent and current symptoms.

Physical Exam:  Examining each joint, looking for tenderness, swelling, warmth and painful or limited movement. 

 Blood tests:       Rheumatoid factor test: Checks for a protein called rheumatoid factor. 

                               Anticitrullinated protein antibody test (anti-CCP): Looks for an antibody that’s  associated with rheumatoid arthritis.

                               Antinuclear antibody test: Tests your immune system to see if it’s producing antibodies as a response to rheumatoid arthritis.

                                Erythrocyte sedimentation rate. Helps determine the degree of inflammation in your body. 

                                C-reactive protein test. A significant inflammation triggers your liver to make C-reactive protein. 

Imaging scans and X-rays:  An X-ray or MRI of a joint can help identify what type of arthritis is present.

Arthrocentesis: In this procedure, joint fluid is drained out for study that can help to exclude other causes of arthritis, such as infection and gout.

Treatment

Medications: Some drugs can help to relieve symptoms and slow disease progression.

Occupational therapy: The individual learns new and effective ways of carrying out daily tasks. This can minimize stress to painful joints.

Surgery: If medication and physical therapy do not help, surgery for total joint replacement or to restore tendons or for the removal of the synovium or fuse a bone or joint is performed.

Home remedies: This includes rest and exercise and following a varied diet with plenty of fresh fruits and vegetables. Tense and painful muscles may benefit from applying a hot pack or a cold treatment.