Rheumatoid arthritis (RA) is a disease in which the immune system does not function in its usual way and destroys joints, including the cartilage and bone. The cause of this disease is unknown, although it is thought that in a person with a family history of RA, an insult such as infection may trigger the immune system to develop the signs and symptoms of this disease.

The usual presentation of symptoms is pain, stiffness, and swelling in multiple joints; this could include fingers, wrists, elbows, shoulders, knees, hips, ankles, and toes. RA does not affect the spine, except in long-standing cases where it can affect the joints of the neck.

Laboratories frequently ordered to test patients for RA include markers of inflammation, such as ESR and CRP. Other helpful tests for diagnosis (not always present, especially at the beginning of symptoms) include rheumatoid factor and anti-citrullinated peptide antibodies.

We are able to diagnose RA much earlier these days with a new set of guidelines published by the American College of Rheumatology. The use of these guidelines provides patients with early intervention and treatment and a more favorable prognosis in terms of progression of disease and quality of life.

I will be providing more information about this topic in future blogs.

Adahli E. Massey, MD, FACR