Dr. M.J. Bazos,
WHAT IS RHEUMATOID
(RA) is a chronic disease that causes pain, stiffness, swelling and loss of
function in the joints and inflammation in other body
the cause of RA remains unknown, rapidly advancing research is discovering the
bodily reactions that lead to arthritis and joint damage. Recent studies show
that certain people inherit a tendency to develop
- RA affects more than two million Americans.
- Direct and indirect costs of RA reached $65
billion in 1992.
- More than 75 percent of RA patients are women.
- Peak onset is between age 20 and 45.
- Osteoporosis is common in patients with RA.
can be difficult to diagnose early because it may begin gradually with subtle
symptoms. Blood tests and X-rays may be normal initially. The disease varies
among individuals with respect to symptoms, joints affected and the nature of
other organs involved, such as the eyes, lungs or skin. Other types of arthritis
may mimic RA. Skill and experience are essential to reach a precise diagnosis
and to arrive at the most appropriate
treatment.The classification criteria
established by the American College of Rheumatology include prolonged morning
stiffness in the joints, characteristic nodules under the skin, joint erosions
apparent on X-ray tests, and blood tests of an antibody known as rheumatoid
for patients with RA has improved dramatically over the last 25 years, offering
most patients good to excellent relief of symptoms and the ability to continue
to function at or near normal levels. There is no cure for RA; therefore, the
goal of treatment is to minimize patients’
symptoms.Successful management of RA
requires early diagnosis and aggressive treatment before functional impairment
and irreversible joint damage has occurred. Nonsteroidal anti-inflammatory drugs
such as ibuprofen may be used first, but all RA patients with persistent
swelling in the joints are candidates for treatment with disease-modifying
drugs. These drugs include methotrexate, hydroxychloroquine, sulfasalzine,
corticosteroids, intramuscular and oral gold, d-penicillamine, minocycline,
azathioprine, cyclosporine, leflunomide, and etanercept.
Optimal treatment requires
comprehensive coordinated care, patient education and the expertise of a number
of providers, including rheumatologists, primary care physicians, nurses,
occupational and physical therapists, physiatrists and orthopedic surgeons. With
the tremendous success of total joint replacement surgery (especially for the
hip and knee) many patients with advanced disease have continued to be active
and mobile.FOR MORE
INFORMATIONContact the Arthritis
Foundation at (800) 283-7800 or visit the Arthritis Foundation web site at