Global InformationRheumatoid arthritis information
| Rheumatoid arthritis | |
|---|---|
 | |
| A hand severely affected by rheumatoid arthritis. This degree of swelling and deformation does not typically occur with current treatment. | |
| Specialty | Rheumatology, Immunology |
| Symptoms | Warm, swollen, painful joints[1] |
| Complications | Low red blood cells, inflammation around the lungs, inflammation around the heart[1] |
| Usual onset | Middle age[1] |
| Duration | Lifelong[1] |
| Causes | Unknown[1] |
| Diagnostic method | Based on symptoms, medical imaging, blood tests[1][2] |
| Differential diagnosis | Systemic lupus erythematosus, psoriatic arthritis, fibromyalgia[2] |
| Medication | Pain medications, steroids, Nonsteroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs[1] |
| Frequency | 0.5–1% (adults in developed world)[3] |
| Deaths | 30,000 (2015)[4] |
Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects joints.[1] It typically results in warm, swollen, and painful joints.[1] Pain and stiffness often worsen following rest.[1] Most commonly, the wrist and hands are involved, with the same joints typically involved on both sides of the body.[1] The disease may also affect other parts of the body, including skin, eyes, lungs, heart, nerves, and blood.[1] This may result in a low red blood cell count, inflammation around the lungs, and inflammation around the heart.[1] Fever and low energy may also be present.[1] Often, symptoms come on gradually over weeks to months.[2]
While the cause of rheumatoid arthritis is not clear, it is believed to involve a combination of genetic and environmental factors.[1] The underlying mechanism involves the body's immune system attacking the joints.[1] This results in inflammation and thickening of the joint capsule.[1] It also affects the underlying bone and cartilage.[1] The diagnosis is made mostly on the basis of a person's signs and symptoms.[2] X-rays and laboratory testing may support a diagnosis or exclude other diseases with similar symptoms.[1] Other diseases that may present similarly include systemic lupus erythematosus, psoriatic arthritis, and fibromyalgia among others.[2]
The goals of treatment are to reduce pain, decrease inflammation, and improve a person's overall functioning.[5] This may be helped by balancing rest and exercise, the use of splints and braces, or the use of assistive devices.[1][6][7] Pain medications, steroids, and NSAIDs are frequently used to help with symptoms.[1] Disease-modifying antirheumatic drugs (DMARDs), such as hydroxychloroquine and methotrexate, may be used to try to slow the progression of disease.[1] Biological DMARDs may be used when the disease does not respond to other treatments.[8] However, they may have a greater rate of adverse effects.[9] Surgery to repair, replace, or fuse joints may help in certain situations.[1]
RA affects about 24.5 million people as of 2015.[10] This is 0.5–1% of adults in the developed world with between 5 and 50 per 100,000 people newly developing the condition each year.[3] Onset is most frequent during middle age and women are affected 2.5 times as frequently as men.[1] It resulted in 38,000 deaths in 2013, up from 28,000 deaths in 1990.[11] The first recognized description of RA was made in 1800 by Dr. Augustin Jacob Landré-Beauvais (1772–1840) of Paris.[12] The term rheumatoid arthritis is based on the Greek for watery and inflamed joints.[13]
- ^ a b c d e f g h i j k l m n o p q r s t u v w x "Handout on Health: Rheumatoid Arthritis". National Institute of Arthritis and Musculoskeletal and Skin Diseases. August 2014. Archived from the original on June 30, 2015. Retrieved July 2, 2015.
- ^ a b c d e Majithia V, Geraci SA (November 2007). "Rheumatoid arthritis: diagnosis and management". The American Journal of Medicine. 120 (11): 936–939. doi:10.1016/j.amjmed.2007.04.005. PMID 17976416.
- ^ a b Smolen JS, Aletaha D, McInnes IB (October 2016). "Rheumatoid arthritis" (PDF). Lancet. 388 (10055): 2023–2038. doi:10.1016/S0140-6736(16)30173-8. PMID 27156434. S2CID 37973054.
- ^ Wang H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, et al. (GBD 2015 Mortality and Causes of Death Collaborators) (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/S0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
- ^ "Rheumatoid arthritis in adults: management: recommendations: Guidance and guidelines". NICE. December 2015. Archived from the original on 2017-04-16.
- ^ Rausch Osthoff AK, Juhl CB, Knittle K, Dagfinrud H, Hurkmans E, Braun J, Schoones J, Vliet Vlieland TP, Niedermann K (2018-12-04). "Effects of exercise and physical activity promotion: meta-analysis informing the 2018 EULAR recommendations for physical activity in people with rheumatoid arthritis, spondyloarthritis and hip/knee osteoarthritis". RMD Open. 4 (2): e000713. doi:10.1136/rmdopen-2018-000713. PMC 6307596. PMID 30622734.
- ^ Park Y, Chang M (January 2016). "Effects of rehabilitation for pain relief in patients with rheumatoid arthritis: a systematic review". Journal of Physical Therapy Science. 28 (1): 304–308. doi:10.1589/jpts.28.304. PMC 4756025. PMID 26957779.
- ^ Singh JA, Saag KG, Bridges SL, Akl EA, Bannuru RR, Sullivan MC, Vaysbrot E, McNaughton C, Osani M, Shmerling RH, Curtis JR, Furst DE, Parks D, Kavanaugh A, O'Dell J, King C, Leong A, Matteson EL, Schousboe JT, Drevlow B, Ginsberg S, Grober J, St Clair EW, Tindall E, Miller AS, McAlindon T (January 2016). "2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis". Arthritis & Rheumatology. 68 (1): 1–26. doi:10.1002/art.39480. PMID 26545940. S2CID 42638848.
- ^ Singh JA, Wells GA, Christensen R, Tanjong Ghogomu E, Maxwell L, Macdonald JK, Filippini G, Skoetz N, Francis D, Lopes LC, Guyatt GH, Schmitt J, La Mantia L, Weberschock T, Roos JF, Siebert H, Hershan S, Lunn MP, Tugwell P, Buchbinder R (February 2011). "Adverse effects of biologics: a network meta-analysis and Cochrane overview". The Cochrane Database of Systematic Reviews. 2011 (2): CD008794. doi:10.1002/14651858.CD008794.pub2. PMC 7173749. PMID 21328309.
- ^ Vos T, Allen C, Arora M, Barber RM, Bhutta ZA, Brown A, et al. (GBD 2015 Disease and Injury Incidence and Prevalence Collaborators) (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
- ^ GBD 2013 Mortality Causes of Death Collaborators (January 2015). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 385 (9963): 117–171. doi:10.1016/S0140-6736(14)61682-2. PMC 4340604. PMID 25530442.
- ^ Landré-Beauvais AJ (1800). La goutte asthénique primitive (doctoral thesis). Paris. reproduced in Landré-Beauvais AJ (March 2001). "The first description of rheumatoid arthritis. Unabridged text of the doctoral dissertation presented in 1800". Joint, Bone, Spine. 68 (2): 130–143. doi:10.1016/S1297-319X(00)00247-5. PMID 11324929.
- ^ Paget SA, Lockshin MD, Loebl S (2002). The Hospital for Special Surgery Rheumatoid Arthritis Handbook Everything You Need to Know. New York: John Wiley & Sons. p. 32. ISBN 978-0-471-22334-4. Archived from the original on 2017-02-22.