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This lesson explores a very common and well-known form of inflammatory arthritis called rheumatoid arthritis. We’ll discuss why it occurs, how it can be diagnosed, how it differs from osteoarthritis, and how it can be treated.

A Really Bad Form of Arthritis

You’ve surely heard of something known as arthritis.

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In short, it’s the inflammation of the joints. It’s painful and can be caused by all sorts of things, ranging from autoimmune diseases to injuries and infections. However, one of the absolute worst forms of arthritis you can get – one that’s extremely painful and even disfiguring – will be discussed in this lesson.

What Is Rheumatoid Arthritis?

This specific form of arthritis is called rheumatoid arthritis, or RA, for short. This is an autoimmune disorder that can commonly affect the joints of the hands and feet. While genetics seem to play a role in the development of this condition, other things may cause you to be more likely to suffer from rheumatoid arthritis. For instance, smoking has been shown to more than double the chances you’ll get this disease.

Another risk factor for developing rheumatoid arthritis is your sex. It seems that women are two to three times more likely to develop this condition than men, although the exact reason for this is unclear.

Causes

What we do know about RA is that there are antibodies that trigger an inflammatory response by reacting and attaching to an individual’s own body’s proteins. These antibodies are called autoantibodies. They are produced by cells of your immune system known as B-cells, which are in turn activated by T-cells. APCA and rheumatoid factor are two types of autoantibodies commonly detected in the blood of rheumatoid arthritis patients.

The autoantibodies trigger the inflammatory response to occur wherever they lodge or attach to. In our case, the place that is most affected by these autoantibodies initially is the synovial membrane of a joint. The synovial membrane is a thin membrane that combines with the fibrous membrane to form the joint capsule. A joint capsule is a sac composed of the fibrous and synovial membranes that surround a joint.So, again, once these autoantibodies attach, they trigger the process of inflammation which first damages the synovial membrane and then the cartilage of the joint itself, resulting in very painful erosions of the cartilage and the disfigurement of the joint.

Usually, antibodies are supposed to do you good. They are launched by your body to try and fight off a foreign invader. But sometimes, be it due to genetics, infections, drugs, and so forth, autoantibodies are produced instead.You can essentially liken the autoantibodies to a heat-seeking missile. It may have been launched against an enemy plane, but got diverted and shot down a friendly plane instead, causing a fiery explosion that we know as inflammation. The fire causes the destruction of anything it comes into contact with, including your joints.

Clinical Signs, Symptoms, and Diagnostics

This inflammatory process causes the typical signs associated with RA:

  • Warm, tender, and swollen joints
  • Pain
  • Rheumatoid nodules, which are swellings, with centers of decaying tissue, that are located underneath the skin overlaying a joint as a result of the inflammation associated with rheumatoid arthritis
  • Fatigue and fever
  • Heart problems

When diagnosing RA, there’s an important consideration.

You need to be able to distinguish osteoarthritis from rheumatoid arthritis. Osteoarthritis is a degenerative arthritis that occurs when wear and tear leads to deterioration of cartilage and overgrowth of bone. Rheumatoid arthritis is the inflammation of a joint’s tissues, which eventually leads to the destruction of cartilage.In fact, let’s play a game of doctor.

You can be the doctor. Read off the list, and make a diagnosis by comparing the two different forms of arthritis that may be occurring in your patient.So in rheumatoid arthritis:

  • It may occur at any time in a person’s life
  • Causes systemic signs, such as fever, fatigue, and heart problems
  • Affects joints on both sides of the body at the same time
  • Causes joint changes more quickly, within a matter of months
  • Joints are more swollen than in osteoarthritis

Osteoarthritis, compared to RA:

  • Typically occurs later in life
  • Doesn’t include systemic signs such as muscle aches, fever, and fatigue
  • Doesn’t affect the joints as rapidly; it may take years to develop
  • Doesn’t cause as much swelling of the joints as rheumatoid arthritis
  • Typically causes symptoms on only one side of the body that may slowly spread to the other side later on

Further testing, through X-rays to look for changes in the joints, and blood tests that look for rheumatoid factor and APCA, can be used to diagnose this condition as well.

Treatment

When you have diagnosed your patient, it’s time to tell them how their rheumatoid arthritis can be treated. Remember, this is an inflammatory condition. Therefore, anti-inflammatory medication, such as non-steroidal, anti-inflammatory drugs like ibuprofen, can be given. This condition is also a result of an aberrant immune system producing autoantibodies. Therefore, immunosuppressant medication, such as high doses of steroids or drugs like cyclosporine, can be used.

If it’s too late for the medication to do anything, then joint replacement therapy, via surgery, may be instituted as well.

Lesson Summary

In this lesson, we went over rheumatoid arthritis, or RA, for short. This is an autoimmune disorder that commonly affects the joints of the hands and feet. APCA and rheumatoid factor are two types of autoantibodies implicated in rheumatoid arthritis. Autoantibodies are antibodies that trigger an inflammatory response by reacting and attaching to an individual’s own body’s proteins.

The autoantibodies trigger the inflammatory response wherever they lodge or attach to. In the case of rheumatoid arthritis, it is the synovial membrane of a joint. The synovial membrane is a thin membrane that combines with the fibrous membrane to form the joint capsule. A joint capsule is a sac composed of the fibrous and synovial membranes that surround a joint. This inflammatory process causes the typical signs associated with RA, including:

  • Warm, tender, and swollen joints
  • Pain
  • Rheumatoid nodules, which are swellings, with centers of decaying tissue, that are located underneath the skin overlaying a joint as a result of the inflammation associated with rheumatoid arthritis
  • Fatigue and fever
  • Heart problems

When diagnosing rheumatoid arthritis, doctors must be careful to distinguish it from osteoarthritis, which is a degenerative arthritis that occurs as a result of wear and tear.

Rheumatoid arthritis can be diagnosed with X-rays, which look for changes in the joints, and blood tests, which look for rheumatoid factor and APCA. Rheumatoid arthritis cannot be cured, but it can be properly treated with anti-inflammatory, immunosuppressive, and surgical means.

Learning Outcomes

After watching this lesson, you should be able to

  • Discuss why rheumatoid arthritis (RA) occurs
  • Identify the signs/symptoms and treatment options
  • Compare/contrast RA to osteoarthritis

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