A type of arthritis in which the joints in the fingers, wrists, toes, or elsewhere in the body become painful, swollen, stiff, and, in severe cases, deformed. Tissues outside the joints, such as the heart, can also be affected. Rheumatoid arthritis is an autoimmune disorder that usually starts in early adulthood or middle age but can also develop in children (see juvenile chronic arthritis) or elderly people. Women are affected more often than men. There are usually recurrent attacks. Symptoms are mild fever and aches followed by swelling, redness, pain, and stiffness in the joints. Ligaments, tendons, and muscles around the joint may also become inflamed. Raynaud’s phenomenon may occur in the fingers, and swelling of the wrist may cause carpal tunnel syndrome and tenosynovitis. Complications caused by severe rheumatoid arthritis include pericarditis, ulcers on the hands and feet, pleural effusion, pulmonary fibrosis, and Sjögren’s syndrome. A diagnosis can be confirmed through X-rays and blood tests. Treatments include non-steroidal anti-inflammatory drugs (NSAIDs); antirheumatic drugs, such as gold, penicillamine, or sulfasalazine; and immunosuppressants, such as azathioprine or corticosteroids. Corticosteroid drugs may also be injected into the joints. Physiotherapy is needed to prevent or limit deformity or to help relieve symptoms and maintain mobility. People who are disabled by arthritis can be helped to cope with everyday tasks through occupational therapy. In severe cases, surgery may be performed to replace damaged joints with artificial ones (see arthroplasty). Most sufferers must take drugs for life, but many can achieve a near-normal level of activity with effective control of symptoms.
Rheumatoid arthritis |
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