What is Rheumatoid   Arthritis?

Read about Rheumatoid Arthritis  Disease presented in simple easy to understand language

Signs and Symptoms
• Joint swelling and pain
• Transient loss of weight 
• Morning stiffness
• Rheumatoid nodules
• Anorexia ( loss of appetite)
• Persistent fatigue and malaise
• Muscle weakness and difficulty in movement. 

However, the symptoms vary from person to person. Some people may have sudden attack of RA while others may have gradual onset. In some, RA is limited to a few joints whereas others have all or most of their joints affected. The symptoms also tend to vary from day-to-day, and month-to-month, with periods when symptoms flare up and settle all by themselves. About one-fifth of people with RA develop rheumatoid nodules, which are lumps of tissue that form under the skin, often over bony areas. These occur most often around the elbow and are usually not a problem. However, they can also be found elsewhere on the body and even in internal organs such as the eye lining or in the lung where they can, in rare cases, cause some pressure effects. 

Laboratory Diagnosis
• Hyprochromic, microcytic anaemia
• E.S.R. elevated, elevated alkaline phosphatase and ferritin. 
• Rheumatoid factor (RF)-titre> 1:80 detectable in 70-80 % of patients with RA. 
• Positive C-Reactive Protein
• Synovial WBC increased ( 3500-50,000)
• Serum – synovial glucose difference >/= 30 mg/dl.

Imaging
• X-ray rarely necessary in diagnosis but useful in following the progression of the disease. In the initial stage, changes are seen either in wrist or ankle joints with soft tissue swelling erosions seen at I.P. joints with gradual space reduction.
• Arthrography to defie joint abnormality or injury to a supporting structure.
• Bone scans if aseptic necrosis is suspected. 
• CT/MRI – useful in specific cases. 

Important Criteria in Diagnosis of RA
There are seven most important symptoms or criteria for the diagnosis of rheumatoid Arthritis. Out of seven criteria, four must be present to rule out rheumatoid Arthritis. 

The seven criteria are
1) Morning stiffness of more than one-hour duration for at least six weeks.
2) Arthritis of at least three joint groups with soft tissue swelling. 
3) Arthritis involving at least one of the following groups: proximal interphalangal, metacarpophalaneal or wrists. 
4) Symmetrical joint swelling. 
5) Subcutaneous nodules
6) Positive RF test. 
7) Radiographic change showing erosion or decalcification of the joint.  Read Previous  Read More...