An Overview of Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a type of chronic inflammatory autoimmune disease.¹

Autoimmune diseases are those in which the immune system mistakenly attacks the cells of the body.² (The prefix “auto,” meaning self, refers to how the immune system attacks the body ie, the “self”.)³
This is different from the typical function of the immune system, which is to attack pathogens such as bacteria and viruses, and unhealthy cells like those damaged by the sun, to protect the body.⁴ 

For patients with RA, the autoimmune response primarily affects the joints, manifesting as joint inflammation.^1,5 Symptoms include swelling and tenderness in the joints, commonly those of the fingers, with smaller joints typically being affected before larger joints.^1,5 Overall, the inflammation caused by RA can lead to progressive destruction of joints and joint deformity, especially if left untreated.^1,5,6

Although it primarily affects the joints, RA is a systemic disease, meaning that the whole body can be affected.⁵ Patients may show involvement of other organs such as the heart and lungs.² Altogether, RA can lead to difficulty with everyday functioning and increased mortality.⁷

Below are typical signs and symptoms of RA, which range from symptoms within the joints to whole body symptoms. 

• Swelling, tenderness, pain, and stiffness of joints^1, 2
• Symmetric involvement of joints²
• Morning stiffness⁵
• Episodes where symptoms get worse, also known as flares²
• Fever, fatigue, and muscle weakness^{2 , 5}
• Joint damage that accumulates over time⁵

Here are some key demographic characteristics of Rheumatoid arthritis

References:
1.Aletaha D, Neogi T, Silman AJ, et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis. 2010; 69:1580-1588.
2.Rheumatoid Arthritis. Centers for Disease Control and Prevention [Document on the Internet]. 2018 Apr 3 [cited 2018 Aug 15]. Available from: https://www.cdc.gov/arthritis/basics/rheumatoid-arthritis.html
3.Stedman’s medical dictionary for the health profession and nursing: Baltimore Maryland: Lippincott Williams & Wilkins. Illustrated 5th ed. 2005.
4.Overview of the Immune System. National Institute of Allergy and Infectious Diseases [Document on the Internet]. 2018 [cited 2018 Aug 15]. Available from: https://www.niaid.nih.gov/research/immune-system-overview
5.Khurana R, Berney SM. Clinical aspects of rheumatoid arthritis. Pathophysiology. 2005; 12:153-165.
6.Smolen JS, Landewe R, Bijlsma J, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update. Ann Rheum Dis. 2017; 76:960-977.
7.Singh JA, Saag KG, Bridges SL Jr, et al. 2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Care Res. 2015; Special Article. doi:10.1002/acr.22783.
8.Gabriel SE, Michaud K. Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases. Arthritis Res Ther. 2009; 11(3):229. doi:10.1186/ar2669.
9.Cross M, Smith E, Hoy D, et al. The global burden of rheumatoid arthritis: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014; 73:1316-1322.
10.Eriksson JK, Neovius M, Ernestam S, Lindblad S, Simard JF, Askling J. Incidence of rheumatoid arthritis in Sweden: a nationwide population-based assessment of incidence, its determinants, and treatment penetration. Arthritis Care Res. 2013; 65(6):870-878.
11.Humphreys JH, Verstappen SMM, Hyrich KL, Chipping JR, Marshal T, Symmons DPM. The incidence of rheumatoid arthritis in the UK: comparisons using the 2010 ACR/EULAR classification criteria and the 1987 ACR classification criteria: results from the Norfolk Arthritis Register. Ann Rheum Dis. 2013; 72:1315-1320.