About Rheumatoid Arthritis

The synovial membrane is a smooth structure that connects bones and joints The immune system can produce substances that cause inflammation of this membrane

The synovial membrane is a smooth structure that connects bones and joints. The immune system can produce substances that cause inflammation of this membrane. When this happens a person develops rheumatoid arthritis. Why this happens is unknown but the inflammation can eventually destroy the joint.

Once the synovial membrane becomes inflamed it produces extra tissue called pannus. The pannus contains enzymes that, once released, eat into the cartilage, bone and soft tissues. Then the tendons become inflamed and shorten. This immobilizes the joint and causes the bones to fuse. It usually affects the knuckles and toe joints but can also develop in the wrists, knees, ankles, and neck. It is uncommon in the spine and hips. They are more vulnerable to osteoarthritis.Rheumatoid arthritis usually develops between age 20 and 45 but it can happen at any time. It starts with fatigue and an aching that resembles the flu. Multiple joints are usually affected in a symmetrical fashion. It will develop on both sides of the body in similar joints. The pain in the joints can be constant even when no movement is involved. Other symptoms are fever, weakness, weight loss, and anemia. Eye problems such as dryness, burning, redness and itching may also occur. The progress of the disease is unpredictable. Symptom can disappear and then recur. Sometimes there is complete remission. However, the disease can also result in severe disability.

Rheumatoid arthritis is difficult to live with, as the patients cannot plan their lives. They may feel well enough to do an activity one day and not be able to get out of bed the next. Their joints are often stiff and painful in the morning but improve during the day. However, they never know for sure if the improvement will happen. The severity of the pain is also unpredictable. One day every movement will be agony and they will have difficulty holding a fork or spoon. The next day the pain will have lessened considerably. So overall they have good days and bad days but they cannot predict when these will occur. Patients with rheumatoid arthritis need to visit their doctors regularly for periodic testing. This includes a C-reactive protein blood test, complete blood cell count, and kidney, liver and urine tests.
After a year X-rays will be taken of the affected joints to evaluate the progress of the deterioration of the joints.

Recent medical advances have brought new hope to patients with rheumatoid arthritis. A new type of drugs that can inhibit the protein that causes the joint inflammation has been developed. This has given new life to many patients. They do have side effects that include difficulty in healing infections and reactivation of tuberculosis.
Another development is leflunomide. This drug is taken orally and limits the activity of the T cells that contribute to the joint damage. This also has side effects such as diarrhea, rash, and hair thinning.
In very rare cases there may be liver problems. People with rheumatoid arthritis are encouraged to follow a healthy diet, avoid stress, and get plenty of rest and exercise. Exercise is important to build bone strength, maintain joint and muscle function, reduce stiffness and relieve pain.

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