Introduction
Rheumatoid arthritis (RA), also known as ledgångsreumatism, is a chronic autoimmune disease that primarily affects the joints. It causes persistent inflammation, pain, swelling, and stiffness, often in multiple joints at the same time. Over time, RA can lead to joint damage, deformity, and loss of function. Early recognition and appropriate management are crucial to control symptoms, prevent joint destruction, and maintain quality of life.
Causes
The exact cause of rheumatoid arthritis is not fully understood, but several factors are known to contribute:
- Immune System Dysfunction: The immune system mistakenly attacks the lining of the joints (synovium), leading to inflammation.
- Genetic Predisposition: A family history of RA or other autoimmune diseases increases the risk.
- Environmental Triggers: Infections, smoking, and other environmental factors may trigger the onset in genetically susceptible individuals.
- Hormonal Factors: RA is more common in women, suggesting a possible hormonal influence.
Symptoms
The main symptoms of rheumatoid arthritis include:
- Joint Pain and Swelling: Persistent pain, tenderness, and swelling in multiple joints, often starting in the fingers, wrists, and toes.
- Stiffness: Joint stiffness, especially in the morning or after periods of inactivity, lasting more than 30 minutes.
- Fatigue: General tiredness and reduced energy levels.
- Warmth and Redness: The skin over affected joints may feel warm or appear red.
- Reduced Range of Motion: Difficulty moving the affected joints.
- Systemic Symptoms: In some cases, RA can cause fever, weight loss, and involvement of other organs such as the eyes, lungs, or heart.
- Joint Deformity: Over time, untreated RA can lead to joint deformities and loss of function.
Diagnosis
Diagnosis is based on clinical evaluation and a combination of tests:
- Medical History: Review of symptoms, duration, and family history.
- Physical Examination: Assessment of joint swelling, tenderness, and range of motion.
- Laboratory Tests: Blood tests for markers of inflammation (CRP, ESR), rheumatoid factor (RF), and anti-cyclic citrullinated peptide (anti-CCP) antibodies.
- Imaging: X-rays, ultrasound, or MRI to assess joint inflammation and detect early joint damage.
- Exclusion of Other Conditions: Ruling out other types of arthritis or joint diseases.
Treatment Options
Treatment aims to control inflammation, relieve symptoms, and prevent joint damage:
- Medications:
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): To reduce pain and inflammation.
- Disease-Modifying Antirheumatic Drugs (DMARDs): Such as methotrexate, to slow disease progression and prevent joint damage.
- Biologic Agents: Target specific parts of the immune system for moderate to severe cases.
- Corticosteroids: Used for short-term control of severe symptoms.
- Physical and Occupational Therapy: Exercises to maintain joint flexibility, strength, and function, and to adapt daily activities.
- Regular Monitoring: Ongoing assessment to adjust treatment and monitor for complications.
- Supportive Care: Education, counseling, and support for the individual and family.
Prevention
There is no known way to prevent rheumatoid arthritis, but early diagnosis and treatment can minimize complications and improve long-term outcomes:
- Awareness of Symptoms: Seek medical advice for persistent joint pain, swelling, or stiffness.
- Healthy Lifestyle: Avoid smoking, maintain a healthy weight, and stay physically active.
- Regular Follow-Up: Ongoing care with a rheumatologist.
Takeaway
Rheumatoid arthritis is a chronic autoimmune disease that can significantly impact joint health and daily life. With early recognition, appropriate treatment, and multidisciplinary support, most individuals can manage symptoms and maintain an active lifestyle. If you experience persistent joint pain and stiffness, consult a healthcare provider for evaluation and personalized care.