Dr. Abhrajit Ray

Rheumatoid Arthritis is a chronic inflammatory disorder effectives small & medium sized joint of hands & feet especially in young ladies aged between 15 to 45 years though it can happen in men & at any age. It affects 0.7% of the Indian population. Healthy life style, avoidance of smoking along with disease modifying drugs (DMARDS) & rarely biologics control the disease. Increase cardio vascular risk, osteoporosis, joint destruction needing orthopaedic surgery & increased susceptibility to infection occurs in uncontrolled cases.

What causes Rheumatoid Arthritis?

RA is an autoimmune disease. This means that certain cells of the immune system do not work properly and start attacking healthy tissues - the joints in RA. The cause of RA is not known. Yet, new research is giving us a better idea of what makes the immune system attack the body and create inflammation. In RA, the focus of the inflammation is in the synovium, the tissue that lines the joint. Immune cells release inflammation-causing chemicals. These chemicals can damage cartilage (the tissue that cushions between joints) and bone. Other things likely play a role in RA as well. For instance, genes that affect the immune system may make some people more prone to getting RA.

How is Rheumatoid Arthritis diagnosed?

RA can be hard to detect because it may begin with subtle symptoms, such as achy joints or a little stiffness in the morning. Also, many diseases behave like RA early on. For this reason, if you or your primary care physician thinks you have RA, you should see a rheumatologist. A rheumatologist is a physician with the skill and knowledge to reach a correct diagnosis of RA and to make the most suitable treatment plan.
Diagnosis of RA depends on the symptoms and results of a physical exam, such as warmth, swelling and pain in the joints. Some blood tests also can help confirm RA. Telltale signs include:
Rheumatoid Arthritis1) Anemia (a low red blood cell count)
2) Rheumatoid factor (an antibody, or blood protein, found in about 80 percent of patients with RA in time, but in as few as 30 percent at the start of arthritis)
3) Antibodies to cyclic citrullinated peptides (pieces of proteins), or anti-CCP for short (found in 60-70 percent of patients with RA)
4) Elevated erythrocyte sedimentation rate (a blood test that, in most patients with RA, confirms the amount of inflammation in the joints)
X-rays can help in detecting RA, but may not show anything abnormal in early arthritis. Even so, these first X-rays may be useful later to show if the disease is progressing. Often, MRI and ultrasound scanning are done to help judge the severity of RA.
There is no single test that confirms an RA diagnosis for most patients with this disease. (This is above all true for patients who have had symptoms fewer than six months.) Rather, a doctor makes the diagnosis by looking at the symptoms and results from the physical exam, lab tests and X-rays.