Rheumatoid arthritis is an autoimmune disorder.Normally, a healthy immune system is programmed to protect the body from harmful foreign bodies like bacteria and viruses but in rheumatoid arthritis the immune system (defense system) of the body, for unknown reasons, starts attacking the body's healthy tissue.The reaction results in inflammation of joints causing reduction in joint space and loss of normal joint shape and alignment.

Important features of Rheumatoid arthritis:

✅It may begin by age 25 and usually before 50 years of age but some times seen in children too.
✅May develop suddenly within a period of weeks/ months but is usually gradual (slow onset)
✅Involves the joints symmetrically i.e.joints on both sides of the body are involved
✅Usually affects the small joints of the hand, foot, wrist, elbow, shoulder or ankle.
✅Causes inflammation resulting in pain and swelling of joints where the joint is warm and tender.
✅Early morning stiffness lasting for more than one hour
✅Causes symptoms in other organs of body besides the joints such as lungs, heart & eyes.
✅May cause overall tiredness, weight loss and occasional fever
✅Finger deformities (‘swan neck' deformity and ‘boutonniere' deformity) are characteristics of RA.

Apart form a detailed medical history and physical examination the doctor will recommend various tests to evaluate and diagnose the condition.
These includes: Blood test for ESR (increase in RA) and blood cell count (shows increase in white blood cells and platelets because of inflammation) . Serology test for Rheumatoid factor (an abnormal antibody), which is present in 70-80% of RA cases.X-ray is usually done to find out the degree of damage that the joint has suffered and later to monitor the progress of the disease.Synovial fluid examination to rule out infection.

Becoming aware about the disease . Taking the medications regularly . Take a diet low in fat, moderate in sugar, rich in Gamma linolenic acid (found in nuts and fish, promrose oil) and omega 3 fatty acids like nuts and fishes like salmon, mackerel, and herring.. Controlling body weight . Taking adequate rest.Acutely involved joints must be given rest or splint to reduce inflammation.. Regular exercise to strengthen muscles (as advised by the doctor) surrounding the involved joints.
Yoga and other alternative therapies have been scientifically documented to complement the use of drugs.

NSAIDs These drugs are mainly used for Pain relief and Anti-inflammatory action.
DMARDs: Methotrexate (Oral & I/V), Salzopyrine, Hydroxychloroquine, Leflunomide.Earlier medicines in this group included Gold salts, D-Penicillamine are less used now.
Advanced treatment of Rheumatoid arthritis.

The Biological: The biologicals are injectible drugs- Tumor necrosis factor Alfa (TNF Alfa) blocking agents and interleukin- 1 receptor antagonist (IL-1ra) are new drugs for RA treatment.They are expensive but have been found to benefit otherwise inadequate response patients.
The anti TNF Alfa agents- Infliximab, Etanercept and adalimumab have set new standards for RA therapy.
Stem Cell implantation: is another new, promising area for the hopeless patients.It is embryonic and adult type- principle is once implanted stem cell has potential to replicate and grow more healthy cells and hence cure the disease.

Smoking tends to increase the Rheumatoid factor (RF) concentration in blood and high concentration of RF is usually associated with severe rheumatoid disease.Besides smokers are more at risk of lung disease.Hence, it is best to quit smoking.

Although Rheumatoid arthritis may affect you daily in long run, early detection of disease and judicious management (with medications, exercise dietary modifications) can easily prevent the progress of your disease, preserve joint movement and prevent deformities.

Frequent Blood tests are required to assess the progress of disease or side effects of medication on vital organs such as liver, kidneys and bone marrow.Your doctor may advise ESR, Hemoglobin, Complete blood count, Liver function test (kidney function test (KFT) at frequent intervals.

Response to treatment may be observed as a general sense of well-being through the course of treatment with adequate treatment there may be decrease in the duration of morning stiffness, decrease in the number of swollen and painful joints.You will be able to perform your daily activities with less discomfort.Monitoring of laboratory parameters such as ESR (Erythrocyte Sedimentation Rate), Rheumatoid factor, C-reactive protein also helps in assessing the disease activity and response to treatment.

Rheumatoid factor is present in blood of approximately 75% of rheumatoid arthritis patients.Those patients having RF in blood are called "Seropositive" whereas remaining 25% who do not have RF in blood are called "Seronegative".Seronegative rheumatoid arthritis patients have a better prognosis than seropositive patients.

High levels of Rheumatoid factor is commonly associated with more severe rheumatoid disease and non-joint manifestation of rheumatoid arthritis such as rheumatoid nodules, rheumatoid lung disease etc.