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Rheumatoid arthritis

Rheumatoid arthritis is a debilitating chronic disease involving joint swelling, joint tenderness, and the destruction of synovial joints, such as the wrists, elbows, shoulders or knees.1  Inflammation of joints may cause ongoing pain, which can make work and household chores difficult for the person.a Besides affecting joints, rheumatoid arthritis can also affect other body systems, including the skin, eyes and nervous system.3

The global prevalence of rheumatoid arthritis is estimated between 0.3-1.0%.2 In Australia, 2% of the population is diagnosed with rheumatoid arthritis, making it the second most common form of arthritis in the country.3

What causes rheumatoid arthritis?

Rheumatoid arthritis is an autoimmune disease, in which the immune system reacts to the body’s own tissues.b Over time, this inflammatory response can lead to joint deformities, such as cartilage destruction and bone erosion.4

A complex interplay between genetic and environmental factors may trigger the development of rheumatoid arthritis.c

  • Rheumatoid arthritis may develop in people with certain inherited genetic factors.4
  • Cigarette smoking is one of the strongest environmental factors linked to rheumatoid arthritis.4
  • Women are 2 to 4 times more likely than men to develop rheumatoid arthritis.5
  • Older people are more likely to develop rheumatoid arthritis.4

What symptoms do people with rheumatoid arthritis have?

In its early stages, rheumatoid arthritis gives rise to symptoms such as swelling, pain, tenderness, joint stiffness, as well as fatigue and weakness.d

The most commonly affected joints in rheumatoid arthritis are the small joints of the hands and feet, as well as the wrists, elbows and knees.e People with rheumatoid arthritis may have visible swelling due to synovitis (inflammation of the membrane that lines the joints).4 The swelling may interfere with day-to-day activities, such as walking, gripping, writing, and cooking.d People with rheumatoid arthritis may also experience stiffness, particularly in the morning.e  Morning stiffness can affect work performance, or lead to tardiness and sick leave from work.f

Rheumatoid arthritis can affect other parts of the body, including:3

  • Skin: Rheumatoid nodules (lumps located in the tissues just under the skin) appear in around one-quarter of people with rheumatoid arthritis3 and indicate more severe disease.e Rheumatoid nodules vary in size and are generally painless.3
  • Eye and mouth: The eyes and mouth of people with rheumatoid arthritis can become dry as a result of decreased tear and saliva production.3
  • Lung: The outer covering of the lung may be inflamed.3
  • Heart: The outer lining of the heart and heart muscles may also be affected by inflammation.3

If the disease worsens, people with rheumatoid arthritis may suffer permanent joint damageg with joint deformities.c

There are many practical things that people with rheumatoid arthritis can to do improve their symptoms, such as maintaining a balanced diet and a healthy weight, as well as exercising regularly.a

Be sure to seek the advice of a medical professional on what is best for you before making dietary changes or starting any exercise programme.

How is rheumatoid arthritis diagnosed?

There is no single diagnostic test for rheumatoid arthritis. Diagnosis in the early stages of the disease is difficult because symptoms vary and overlap with other forms of arthritis.3

In general, the diagnosis of rheumatoid arthritis is based on clinical assessment, laboratory tests, and X-rays.

  • The initial clinical assessment is based on the symptoms, the pattern of joints involved, and the person’s medical history.3
  • Laboratory tests measure the levels of autoantibodies (a type of protein) in the blood. The presence of autoantibodies, such as rheumatoid factor, supports the diagnosis of rheumatoid arthritis.3
  • X-rays detect damage to joints.3

What are the resources available to people with rheumatoid arthritis and their caregivers?

Patient Organisations:

Arthritis Australia is a charitable not-for-profit organisation, and is the peak arthritis body in Australia. Resources available through its website include arthritis information sheets, booklets and news. To find a support group near you, please select one of the following: 

The Australian Rheumatology Association  is an association of rheumatologists in Australia that is a specialty society of the Royal Australasian College of Physicians. The Patient’s Home webpage offers people with diseases that affect the joints, muscles, and bones an extentive range of information, including medicine information sheets and consumer information sheets.

For more information about rheumatoid arthritis, please consult a healthcare professional.

References 

1. Aletaha D, Neogi T, Silman A, et al. Arthritis & Rheumatism. 2010;62:2569-2581.   http://onlinelibrary.wiley.com/doi/10.1002/art.27584/pdf

2. Taylor P, Moore A, Vasilescu R, et al. Rheumatology International. 2016:1-11.   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4839053/

3. Australian Institute of Health and Welfare. A picture of rheumatoid arthritis in Australia. Canberra: AIHW, 2009. Available from http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442459857

4. Wasserman A. American Family Physician. 2011;84(11):1245-1252 http://www.aafp.org/afp/2011/1201/p1245.html

5. Karlson E, Deane K. Rheumatic Diseases Clinics of North America. 2012;38:405-426. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3402910/