Rheumatoid Rheumatoid Arthritis, with sex being less significant

Arthritis (RA)


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            Rheumatoid Arthritis is a commonly diagnosed systemic
inflammatory disease characterized by pain, stiffness and inflammation of the
joints.  Although it primarily affects
synovial or flexible joints, it can also produce inflammation in the membrane
around the heart, lungs, whites of eye, as well as various organs and tissues. Rheumatoid
Arthritis is a painful and debilitating disease with physical and emotional
effects that impact the health and lifestyle of the affected.


 The cause of Rheumatoid Arthritis has yet to
be identified however it is attributed to autoimmunity.  As identified by Shimerling in the Health reference series: Harvard Medical
School health topics A-Z,
it appears to be an autoimmune disease in which the body’s immune system
attacks heathy tissue resulting in damage to the cartilage, bone, tendons and
ligaments near the joints. The bodies autoimmune response causes inflammation
which can cause further damaged it left untreated.  Joint nodules (known as nodules), weakness, loss
of mobility, joint deformity and even fractures may result.   More recent discussion, suggests that a virus
triggers this faulty immune response, however there is not yet enough evidence
that a virus is the cause of Rheumatoid Arthritis (Shimerling 2017).

            Many factors both genetic and environmental such as age,
sex, smoking and inactivity are considered in the diagnosis of the
disease.  “Older age, family history of
the disease and female sex are associated with increased risk of Rheumatoid
Arthritis, with sex being less significant in older patients while smokers both
current and past have an increased rate of suffering from Rheumatoid Arthritis
(Wasserman, Amy 2001).”  Hochberg,
Silman, Smolen, Weinblatt and Weismann provide evidence in their study of
female health professionals that smoking is a factor in increased risk.  This study concluded that there is a link
between duration of smoking and increased risk of RA; women who had smoked for
more than 20 years were found to have a 39% increased risk and this was
increased to 49% for seropositive for the disease. Although it is uncommon for
children to be affected by Rheumatoid Arthritis, it is still a possibility
although the incidences are much less than those of adults.

            More common symptoms include those that manifest in the
joints such as pain, stiffness and inflammation however fatigue, low grade
fever, weight loss, trouble sleeping, depression, weakness and mobility may
also be helpful in the diagnosis. Because the latter symptoms are not specific
to joints, they may be mistaken with other autoimmune diseases that share these
symptoms making a diagnosis more difficult. 
Family history, a physical joint exam, blood tests and imaging tests can
all provide key information in the  diagnosis of Rheumatoid Arthritis. Blood tests
are necessary in testing for the presence of the antigen known as rheumatoid
factor (RF) however in some cases, individual’s results show negative, known as
seronegative. Whether the result be positive or negative, further testing my be
necessary to confirm a diagnoses and monitor progression of the disease.

            Rheumatoid arthritis cannot be cured but many treatments
exist to alleviate the symptoms and delay its progression.  In less severe cases or during the early
stages of the disease, analgesic drugs can provide pain relief, anti-inflammatory
drugs help with joint inflammation, an exercise and physiotherapy help maintain
muscle tone. For more acute cases cortisone or steroids may be necessary to
provide relief from symptoms of pain and inflammation. Non-steroidal
anti-inflammatory drugs (NSAIDs) such as naproxen, diclofenac and ibuprofen,
relieve both pain and swelling of joints (Hochberg, Silman, Smolen, Weinblatt,
& Weismann 2008).    The
Hutchinson unabridged encyclopedia with atlas
and weather guide identifies a group of antirheumatic drugs such as
methotrexate, cyclosporine A, D-penicillamine and several TNF inhibitors which
slow down the progression of the disease. In a final effort to seek relief in
more advanced stages, some patients opt for joint replacements (arthroplasty)
in order to maintain mobile. The physical symptoms as well as the emotional
effects of Rheumatoid Arthritis can interfere with activities of our daily life,
and negatively impact out relationships and well beings therefore prompt and
appropriate treatment is necessary in managing the disease (Keith 2016)


            Rheumatoid Arthritis is a painful and progressive disease
which can affect much more than the joints we commonly associate it with. Risk
factors include both genetic and environmental, and lifestyle modifications
such as not smoking, may reduce some environmental risks. Although Rheumatoid
Arthritis cannot be cured, proper diagnosis and treatment help make the disease
more manageable and less debilitating.