Rheumatoid Arthritis

• Rheumatoid arthritis is an autoimmune disorder that primarily affects joints.
• It occurs when the immune system mistakenly attacks the body’s tissues, causing inflammation in the joint lining.

Overview of Rheumatoid Arthritis:

• It is a chronic autoimmune disorder that primarily affects the joints, causing inflammation, pain, and potential joint destruction.
• It can also have systemic effects, impacting various organs and systems in the body.

Symptoms of Rheumatoid Arthritis:

• The symptoms of this arthritis can vary in severity and may include:
  1. Joint pain and tenderness
  2. Joint stiffness, especially in the morning or after periods of inactivity
  3. Swelling in the joints
  4. Redness and warmth around the affected joints
  5. Fatigue
  6. Fever
  7. Weight loss
  8. Rheumatoid nodules (firm lumps under the skin, often around pressure points)
  9. Reduced range of motion

Etiology of Rheumatoid Arthritis:

• The exact cause of rheumatoid arthritis is unknown, but several factors are believed to contribute to its development:
  1. Genetic factors – Certain genetic markers, such as HLA-DR4, increase the risk of developing RA.
  2. Environmental factors – Smoking, exposure to certain infections, and other environmental factors can trigger the onset of RA in genetically predisposed individuals.
  3. Immune system abnormalities – RA is an autoimmune disorder where the immune system mistakenly attacks the synovium (lining of the membranes surrounding the joints).

Pathogenesis of Rheumatoid Arthritis (RA)

• Rheumatoid arthritis is an autoimmune disorder primarily affecting joints.
  1. Genetic Predisposition: Genetic factors, such as HLA-DR4, increase susceptibility.
  2. Immune System Dysfunction: Autoantibodies (e.g., rheumatoid factor, anti-CCP) target joint synovium, leading to chronic inflammation.
  3. Synovitis: Inflammation of the synovial membrane results in pannus formation, which invades and destroys cartilage and bone.
  4. Cytokines: Pro-inflammatory cytokines (TNF-α, IL-1, IL-6) drive the inflammatory response and joint destruction.

Treatment

• There is no cure for rheumatoid arthritis, but treatments can help manage symptoms and slow disease progression.
• Treatment options include:

1. Medications:

   1. NSAIDs: Reduce pain and inflammation.
   2. Corticosteroids: Provide quick relief from inflammation.
   3. DMARDs: Slow disease progression (e.g., methotrexate, leflunomide).
   4. Biologic Agents: Target specific parts of the immune system (e.g., TNF inhibitors).

2. Physical therapy

   • Helps maintain joint flexibility and muscle strength.

3. Occupational therapy

   • Assists in adapting daily activities to reduce strain on the joints.

4. Surgery

   • In severe cases, surgical options like joint replacement or synovectomy may be considered.

5. Lifestyle modifications

   • Regular exercise, a balanced diet, stress management, and smoking cessation can help manage symptoms and improve quality of life.

Prevention

• While there is no known way to prevent rheumatoid arthritis, early diagnosis and treatment can help manage the disease effectively and reduce the risk of joint damage.
• Maintaining a healthy lifestyle, avoiding smoking, and regular medical check-ups are important in managing risk factors associated with RA.

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