21/10/2025
Rheumatoid Arthritis (RA)π§π©Ίπ
Rheumatoid arthritis is a chronic, systemic autoimmune disease that primarily affects the joints, causing inflammation of the synovial membrane leading to pain, swelling, stiffness, and deformity.
πPathophysiology
β’ The immune system attacks the synovium (lining of joints).
β’ This causes chronic inflammation, leading to:
β’ Synovial thickening (pannus formation)
β’ Cartilage destruction
β’ Bone erosion and joint deformity
β’ It can also affect other organs (heart, lungs, skin, eyes, blood vessels).
πSigns and Symptoms
Joint-related:
β’ Symmetrical joint pain and swelling (usually small joints: hands, wrists, feet)
β’ Morning stiffness lasting >30 minutes
β’ Warm, tender joints
β’ Limited range of motion
⒠Deformities (swan neck, boutonnière, ulnar deviation)
Systemic symptoms:
β’ Fatigue, fever, malaise
β’ Weight loss
β’ Rheumatoid nodules (firm lumps under skin near joints)
πDiagnosis
1. Laboratory Tests
β’ β Rheumatoid factor (RF)
β’ β Anti-CCP antibodies (highly specific)
β’ β ESR and CRP (indicate inflammation)
β’ Mild anemia (anemia of chronic disease)
2. Imaging
β’ X-ray: joint space narrowing, bone erosion
β’ Ultrasound or MRI: early joint inflammation
πTreatment
Goals: reduce inflammation, relieve pain, prevent joint damage
1. Medications
β’ NSAIDs: relieve pain and stiffness (e.g., ibuprofen, naproxen)
β’ Corticosteroids: short-term control of inflammation (e.g., prednisone)
β’ DMARDs (Disease-Modifying Antirheumatic Drugs): slow disease progression
β’ Methotrexate (first-line)
β’ Sulfasalazine
β’ Leflunomide
β’ Hydroxychloroquine
β’ Biologic Agents: target immune system components
β’ Etanercept, Infliximab, Adalimumab (anti-TNF agents)
β’ Tocilizumab, Rituximab (other biologics)
2. Non-Pharmacological
β’ Physical therapy and gentle exercise
β’ Heat/cold application
β’ Joint protection (splints, assistive devices)
β’ Balanced diet (anti-inflammatory foods, omega-3)
β’ Smoking cessation
3. Surgical Management
β’ Joint replacement (arthroplasty) in severe cases
β’ Synovectomy (removal of inflamed synovium)
