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Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune disorder that causes the body's
immune system to attack the bone joints. It is a disabling condition,
and often thought of as a disease.
The synovium can become irritated and thickened with this condition, and
sometimes it must be surgically removed.
Diagnosis
Diagnosis is with immunological studies, such as rheumatoid factor (a
specific antibody) which can be negative; when this happens the
arthritis is seronegative.
The American College of Rheumatology has defined (1987) the following
criteria for Rheumatoid Arthritis [1]:
Morning stiffness of >1 hour.
Arthritis and soft-tissue swelling of >3 of 14 joints/joint groups
Arthritis of hand joints
Symmetric arthritis
Subcutaneous nodules in specific places
Rheumatoid factor at a level above the 95th percentile
Radiological changes suggestive of joint erosion
Four criteria have to be met, although many patients are treated despite
not meeting the criteria.
Treatment
Treatment is with NSAIDs, although most patients will proceed to
treatment with steroids, DMARDs (disease-modifying antirheumatic drugs),
and monoclonal antibodies (anti-TNF-alpha, e.g. infliximab or etanercept).
Other therapies are weight loss, physiotherapy and special tools to
improve hard movements (e.g. special tin-openers).
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