DR. CORA LIM-MEDICAL INSIDER

Rheumatic Fever (RF), Systemic Lupus Erythmatosus, and other Diseases 

(Part 1)

Another disease that we will discuss now is what we call as Rheumatoid Arthritis (RA)

What is Rheumatoid Arthritis? This is an auto immune and inflammatory disease, which means that your immune system attacks healthy cells in your body by mistake, causing inflammation (painful swelling) in the affected parts of the body. RA mainly attacks the joints, usually many joints at once.

What is the Approach to Arthritis Treatment
Regardless of the type of arthritis, the treatment goals are the same. These are: Optimize treatment of pain & inflammation; Minimize joint damage; Maximize functional independence; Provide access to care at reasonable cost; and Enhance quality of life.

What are the Classification Criteria for Rheumatoid Arthritis (Requires four out of the seven criteria): Morning stiffness, Arthritis of three or more joints, Arthritis of hand joints, Symmetric arthritis, Rheumatoid nodules, Serum rheumatoid factor, Radiologic changes, Must have been present for at least six weeks

What are the main causes of Rheumatoid Arthritis?

According to research, RA is caused by a combination of genetics, hormones and environmental factors. Normally, your immune system protects your body from disease. With rheumatoid arthritis, something triggers your immune system to attack your joints. Some of these include an infection, smoking or physical or emotional stress may be triggering.

Can rheumatoid arthritis be cured?

While it is true that there’s no cure for rheumatoid arthritis, early treatment and support (like medicine, lifestyle changes, supportive treatments and surgery) can reduce the risk of joint damage and limit the impact of the condition.

What are some of the symptoms of RA?

People with RA may not see redness or swelling in the joints, but they may experience tenderness and pain. This is in the early stages of RA. The following symptoms may be clues to RA:

  • Joint pain, tenderness, swelling or stiffness that lasts for six weeks or longer.
  • Morning stiffness that lasts for 30 minutes or longer.
  • More than one joint is affected.
  • Small joints (wrists, certain joints in the hands and feet) are typically affected first.
  • The same joints on both sides of the body are affected.

Note: Let us remember that there are some people with RA who get very tired and some may have a low-grade fever. RA symptoms may come and go. Having a lot of inflammation and other symptoms is called a flare. A flare can last for days or months. 

What are the Health Effects of RA?

These are some of the health effects of RA:

  • As far as the eyes are concerned, there will be dryness, pain, inflammation, redness, sensitivity to light and trouble seeing properly.
  • For the mouth, there will also be dryness and gum inflammation, irritation or infection. 
  • For the skin, there will be Rheumatoid nodules. These are small lumps under the skin over bony areas. 
  • The lungs will also be affected as there will be lung inflammation and scarring that can lead to shortness of breath and lung disease.
  • The blood vessels will also have inflammation that can lead to damage in the nerves, skin and other organs.
  • As far as blood is concerned, there is going to be a lower than normal number of red blood cells. 
  • For the heart, we know that inflammation can damage the heart muscle and the surrounding areas.
  • Painful joints also make it hard to exercise, leading to weight gain. Being overweight may make people with RA more likely to develop high cholesterol, diabetes, heart disease and high blood pressure. (To be continued).