| Rheumatoid arthritis is the most common inflammatory | | | | develop and be accompanied by loss of function. |
| form of arthritis. It is considered an autoimmune | | | | Morning stiffness is a key component of rheumatoid |
| disease- a disease where the immune system attacks | | | | arthritis. This generally lasts more than an hour. Patients |
| the joints. This article discusses how a rheumatologist | | | | may also complain of stiffness during the day if they |
| makes the diagnosis early on. | | | | sit for any length of time. |
| The cause of the immune abnormality that occurs in | | | | Examination may reveal swelling affecting multiple |
| rheumatoid arthritis still has no definite explanation. | | | | joints , both small and large- although small joints of the |
| Some suspect an environmental trigger such as a | | | | hands, wrists, ankles, and feet are moist commonly |
| virus or bacterium interacts with specific genes that a | | | | involved. |
| patient may have. This leads to a cascade of events | | | | Bumps under the skin near joints such as the fingers |
| culminating in inflammation. The immune attack occurs | | | | and elbows may occur. These are called rheumatoid |
| at the site of the synovium- the lining of the joints. | | | | nodules. |
| White blood cells flood this area and release | | | | Laboratory tests are helpful. Elevation of erythrocyte |
| destructive enzymes. This sequence of events leads | | | | sedimentation rate (ESR) or C-reactive protein indicate |
| to inflammation of the synovium, erosion of cartilage | | | | systemic inflammation. A positive rheumatoid factor is |
| and bone, and subsequent weakening of tendons, | | | | seen in about 80-85% of patients. The rheumatoid |
| ligaments, and muscles. Because it is a systemic illness, | | | | factor may be negative early on and may be |
| rheumatoid arthritis may affect other organ systems in | | | | persistently negative in 20% of patients. Anti-CCP- a |
| the body such as the eyes and heart. | | | | new diagnostic test — is more specific for |
| Early diagnosis is not always easy. The joint swelling | | | | rheumatoid arthritis than the rheumatoid factor, which |
| that is characteristic of rheumatoid arthritis may not be | | | | may be positive in other conditions. |
| that pronounced. Sometimes fatigue, low-grade fever, | | | | Magnetic resonance imaging (MRI) and diagnostic |
| weight loss, loss of appetite, and stiffness, may be the | | | | ultrasound are helpful imaging tests for early diagnosis. |
| chief symptoms- but these symptoms can occur with | | | | X-rays may not become positive until a patient has |
| other diseases as well! | | | | had their disease for at least six months and are |
| Over a period of a few weeks to months, joint | | | | therefore not useful for early diagnosis. |
| symptoms such as pain, redness, and swelling can | | | | |