This is a chronic progressive inflammatory autoimmune disease mainly affecting peripheral synovial joints. It is a systematic disorder in which inflammatory changes affect not only joints but also many other sites including the heart,blood vessels and skin.
The cause is not clearly understood but development of autoimmunity may be initiated by microbial infection,possibly by viruses,in genetically susceptible people. Risk factors include:
- Age- risk increases with age.
- Gender- premenopausal women are affected three times as commonly as men.
- Genetic risk- there is a strong familial link in some cases,and some markers on the surface membranes of white blood cells have also been associated with higher risk of the disease.
High levels of rheumatoid factor,especially early in the disease,are strong associated with accelerated and more severe disease. Symptoms include joint pain and stiffness,particularly in the morning and after rest. Joints can be visibly swollen,hot and tender.
Acute exacerbations of rheumatoid arthritis are usually accompanied by fever,and are interspersed with periods of remission. The joints most commonly affected are those of the hands and feet,but in severe cases most synovial joints may be involved. With each exacerbation there is additional and cumulative damage to the joints,leading to increasing deformity,pain and loss of function.
