Rheumatoid Arthritis

Disease Summary

Rheumatoid arthritis (RA) is a long-term disease that causes pain, stiffness, swelling, and limited motion and function of many joints. While RA can affect any joint, the small joints in the hands and feet tend to be hit the hardest. Swelling can affect organs as well, especially the eyes or lungs. The stiffness seen in active RA is often worse in the morning. It may last one to two hours or as long as an entire day. The goal of RA treatment is to reduce pain and swelling in the joints, increase joint function, and slow down or prevent joint destruction or deformity. Proper treatment can improve function, stop damage to your joints, and prevent disability and the need for surgery.


Types of Rheumatoid Arthritis

There are multiple types of rheumatoid arthritis, seropositive rheumatoid arthritis or seronegative rheumatoid arthritis. This difference can determine treatment options.

Seropositive

Rheumatoid arthritis patients who are classified as seropositive have the presence of anti-cyclic citrullinated peptides (anti-CCPs) in their blood test results. These are also referred to as anti-citrullinated protein antibodies (ACPAs). These are the antibodies that attack the body and produce the symptoms of rheumatoid arthritis. Between 60 and 80% of rheumatoid arthritis patients test positive for the presence of anti-CCPs. The presence of these antibodies can be detected as early as 5 to 10 years before clinical rheumatoid arthritis symptoms appear.

Seronegative

It’s still possible for patients to develop rheumatoid arthritis without the presence of antibodies in their blood. This is referred to as seronegative type rheumatoid arthritis. Seronegative patients are those who do not test positive for the anti-CCPs or another antibody called rheumatoid factor. Though seronegative patients lack the antibodies that help doctors diagnose the condition, they can still be diagnosed with rheumatoid arthritis in a number of ways. These include the demonstration of clinical rheumatoid arthritis symptoms, as well as X-ray results indicating patterns of cartilage and bone deterioration. Though it’s possible for seronegative patients to have milder rheumatoid arthritis symptoms than seropositive patients, this isn’t always the case. It can still depend on a number of factors, including genetics and other underlying conditions as well.

Juvenile Rheumatoid Arthritis

Juvenile rheumatoid arthritis is another type that affects patients under the age of 17 years old. It is also known as juvenile idiopathic (unknown cause) arthritis. It is the most common type of arthritis for this age group and symptoms can be persistent. Swelling, stiffness and pain in the joints can last months for those suffering from juvenile rheumatoid arthritis. Some patients may experience rheumatoid arthritis symptoms for the rest of their lives.

The effects of juvenile rheumatoid arthritis differ from those seen in adult patients because children and youth can experience growth issues as a result of the disease. Eye and lymph node inflammation are also a concern.

Like adult patients, juvenile rheumatoid arthritis is diagnosed from a series of different blood tests including testing for rheumatoid factor and the presence of anti-CCPs. In some cases, doctors may not be able to detect abnormalities in the blood tests of children and youth who have clinical symptoms.


Other Associated Conditions

Increasingly, researchers are finding that rheumatoid arthritis patients may develop other chronic conditions alongside their rheumatoid arthritis symptoms. Some of these conditions precede rheumatoid arthritis symptoms while some develop afterward. Some of these other conditions may include:

  • Ankylosing Spondylitis disease
  • Sjogren’s Syndrome
  • Psoriasis
  • Felty’s Syndrome
  • Lupus
  • Anemia
  • Lyme disease

Common symptoms of RA

  • Tiredness
  • Lack of appetite
  • Low fever
  • Muscle and joint stiffness
  • Smaller range of motion that lasts longer than 30 minutes in the morning or after a long rest
  • Similar achy joints on both sides of the body
  • Tender, warm, swollen joints, usually in the wrist and knuckles
  • Having trouble turning doorknobs and opening jars

Risk for Comorbid Conditions

Individuals with rheumatoid arthritis are at an increased risk to develop other chronic and serious health conditions also known as comorbid disease. These include heart disease, obesity, diabetes, eye conditions and depression. It is recommended to discuss these risks with a health care professional.