RHEUMATOID

ARTHRITIS
WHAT IS RHEUMATOID
ARTHRITIS?
• Is an autoimmune disease in which the immune system of the body attacks its
own tissue (its own cartilage and joint linings)

• Characterized by inflammation of the joint, which causes swelling, pain, and

loss of function.

• Usually occurs bilaterally: If one wrist is affected, the other is also likely to be
affected, although they are often not affected to the same degree.
• The primary symptom of RA is inflammation of the synovial membrane. If
untreated, the membrane thickens, and synovial fluid accumulates. The
resulting pressure causes pain and tenderness.

• The membrane then produces an abnormal granulation tissue, called pannus,

that adheres to the surface of the articular cartilage and sometimes erodes
the cartilage completely.

• When the cartilage is destroyed, fibrous tissue joins the exposed bone ends.
• The fibrous tissue ossifies and fuses the joint so that it becomes immovable ─ the
ultimate crippling effect of RA. Growth of the granulation tissue causes the
distortion of the fingers that characterizes hands of RA sufferers.
SHOWN ARE SWAN−NECK
DEFORMITY, ULNAR

DEVIATION, DORSAL INTEROSSEOUS

ATROPHY, AND

SWELLING OF WRIST
DIAGNOSIS

• Diagnostic testing for RA primarily involves RF assays

• Rapid agglutination
• Low serum iron levels and a normal or low iron-binding capacity are common
features in RA
• ESR is elevated to a variable degree in most RA patients and roughly
parallels the level of disease activity.
TREATMENT
Main goals of treatment :
• reduce pain and discomfort
• prevent deformities and loss of joint
function
• help the patient maintain a productive
and active life.
• Nonsteroidal Anti-inflammatory
Drugs − reduce acute inflammation
• Corticosteroids and Glucocorticoids
− have anti−inflammatory and
immunoregulatory activity, oral
corticosteroids can produce a
variety of complications, including
high blood pressure, increased
susceptibility to infection, and
osteoporosis
• Disease-Modifying Antirheumatic Drugs (DMARDs): methotrexate,
intramuscular gold salts, hydroxychloroquine, sulfasalazine, D−penicillamine,
and immunosuppressive and other cytotoxic drugs.

• Other Drugs: antimalarial drugs

• Inflammation must be suppressed and mechanical and structural

abnormalities corrected or compensated for with assistive devices. Treatment
options include reduction of joint stress, physical and occupational therapy,
drug therapy, and surgical intervention.