Rheumatoid Arthritis

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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• Rheumatoid Arthritis Overview
• How Rheumatoid Arthritis Affects the Entire Body
• Rheumatoid Arthritis Causes
• Rheumatoid Arthritis Symptoms and Signs
• When to Seek Medical Care
• Questions to Ask the Doctor
• Rheumatoid Arthritis Diagnosis
• Rheumatoid Arthritis Classification
• Rheumatoid Arthritis Treatment
• Self-Care at Home
• Medical Treatment
• Rheumatoid Arthritis Medications
• Disease-Modifying Antirheumatic Drugs (DMARDs)
• Biologic Response Modifiers and Glucocorticoids
• Nonsteroidal Anti-inflammatory Drugs (NSAIDs) and Analgesics
• Surgery for Rheumatoid Arthritis
• Other Therapy
• Follow-up
• Rheumatoid Arthritis Prevention
• Rheumatoid Arthritis Prognosis
• Rheumatoid Arthritis Support Groups and Counseling
• For More Information
• Web Links
• Synonyms and Keywords
• Authors and Editors
• Read more on Rheumatoid Arthritis from Healthwise
• Rheumatoid Arthritis FAQs
• Viewer Comments: Rheumatoid Arthritis - Treatment
• Viewer Comments: Rheumatoid Arthritis - Medications
• Viewer Comments: Rheumatoid Arthritis - Early Symptoms

Rheumatoid arthritis is a chronic joint disease that damages the joints of the body. It is also a systemic disease that potentially affects internal organs of the body and leads to disability. The joint damage is caused by inflammation of the joint lining tissue. Inflammation is normally a response by the body's immune system to "assaults" such as infections, wounds, and foreign objects. In rheumatoid arthritis, the inflammation is misdirected to attack the joints. Rheumatoid arthritis is often referred to as RA.

• The inflammation in the joints causes pain, stiffness, swelling, and loss of function.
• The inflammation often affects other organs and systems of the body, including the lungs, heart, and kidneys.
• If the inflammation is not slowed or stopped, it can permanently damage the affected joints and other tissues.

Rheumatoid arthritis should not be confused with other forms of arthritis, such as osteoarthritis or arthritis associated with infections. Rheumatoid arthritis is an autoimmune disease. This means that the body's immune system mistakenly attacks the tissues it is supposed to protect.

• The immune system produces specialized cells and chemicals, which are released into the bloodstream and begin to attack body tissues.
• This abnormal immune response causes inflammation and thickening of the membrane (synovium) that lines the joint. Inflammation of the synovium is called synovitis and is the hallmark of an inflammatory arthritis such as rheumatoid arthritis.
• As the synovitis expands inside and outside of the joint, it can damage the bone and cartilage of the joint and the surrounding tissues, such as ligaments, tendons, nerves, and blood vessels.

Rheumatoid arthritis most often affects the smaller joints, such as those of the hands and/or feet, wrists, elbows, knees, and/or ankles, but any joint can be affected. The symptoms often lead to significant discomfort and disability.

• Many people with rheumatoid arthritis have difficulty carrying out normal activities of daily living, such as standing, walking, dressing, washing, using the toilet, preparing food, and carrying out household chores.
• The symptoms of rheumatoid arthritis interfere with work for many people. As many as half of those with rheumatoid arthritis are no longer able to work 10-20 years after their condition is diagnosed.
• On average, life expectancy is somewhat shorter for people with rheumatoid arthritis than for the general population. This does not mean that everyone with rheumatoid arthritis has a shortened life span. Rheumatoid arthritis itself is not a fatal disease. However, it can be associated with many complications and treatment-related side effects that can contribute to premature death.

Although rheumatoid arthritis most often affects the joints, it is a disease of the entire body. It can affect many organs and body systems besides the joints. Therefore, rheumatoid arthritis is referred to as a systemic disease.

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