Joint abnormalities in rheumatoid arthritis
Find information on thousands of medical conditions and prescription drugs.

Rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic, inflammatory autoimmune disorder that causes the immune system to attack the joints. It is a disabling and painful inflammatory condition, which can lead to substantial loss of mobility due to pain and joint destruction. more...

Gastroesophageal reflux...
Rasmussen's encephalitis
Raynaud's phenomenon
Reactive arthritis
Reactive hypoglycemia
Reflex sympathetic...
Regional enteritis
Reiter's Syndrome
Renal agenesis
Renal artery stenosis
Renal calculi
Renal cell carcinoma
Renal cell carcinoma
Renal cell carcinoma
Renal failure
Renal osteodystrophy
Renal tubular acidosis
Repetitive strain injury
Respiratory acidosis
Restless legs syndrome
Retinitis pigmentosa
Retrolental fibroplasia
Retroperitoneal fibrosis
Rett syndrome
Reye's syndrome
Rh disease
Rheumatic fever
Rheumatoid arthritis
Rift Valley fever
Rocky Mountain spotted fever
Romano-Ward syndrome
Roseola infantum
Rubinstein-Taybi syndrome
Rumination disorder

The disease is also systemic in that it often also affects many extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and muscles.

The name is derived from the Greek rheumatos meaning "flowing", the suffix -oid meaning "in the shape of", arthr meaning "joint" and the suffix -itis, a "condition involving inflammation".


Rheumatoid arthritis is a chronic, inflammatory multisystem autoimmune disorder. It commonly affects the joints in a polyarticular manner (polyarthritis). The symptoms that distinguish rheumatoid arthritis from other forms of arthritis are inflammation and soft-tissue swelling of many joints at the same time (polyarthritis). The joints are generally affected in a symmetrical fashion. The pain generally improves with use of the affected joints, and there is usually stiffness of all joints in the morning that lasts over 1 hour. Thus, the pain of rheumatoid arthritis is usually worse in the morning compared to the classic pain of osteoarthritis where the pain worsens over the day as the joints are used.

If the arthritis has been longstanding, the inflammatory activity has led to erosion and destruction of the joint surface, which impairs their range of movement and leads to deformity. The fingers are typically deviated towards the little finger (ulnar deviation) and can assume unnatural shapes. Classical deformities in Rheumatoid arthritis are the Boutonniere deformity (Hyperflexion at the proximal interphalangeal joint with hyperextension at the distal interphalangeal joint), Swan neck deformity (Hyperextension at the proximal interphalangeal joint, hyperflexion at the distal interphalangeal joint). The thumb may develop a "Z-Thumb" deformity with fixed flexion and subluxation at the metacarpophalangeal joint, leading to a "squared" appearance in the hand.

Subcutaneous nodules on extensor surfaces, such as the elbows, are often present.

Extra-articular manifestations also distinguish this disease from osteoarthritis (hence it is a multisystemic disease). Haematological: Most patients also suffer of anemia, either as a consequence of the disease itself (Anaemia of Chronic disease) or as a consequence of gastrointestinal bleeding as a side effect of drugs used in treatment, especially NSAIDs (non-steroidal anti-inflammatory drugs) used for analgesia. Splenomegaly may occur (Felty's syndrome).

Dermatological: Subcutaneous nodules

Pulmonary: The lungs may become involved as a part of the primary disease process or as a consequence of therapy. Fibrosis may occur spontaneously or as a consequence of therapy (for example methotrexate). Caplan's nodules are found as are pulmonary effusions.


[List your site here Free!]

Can statins benefit patients with rheumatoid arthritis?
From American Family Physician, 4/1/05 by Anne D. Walling

Statins were developed for their antilipid properties, but they also act as anti-inflammatories. In vitro studies indicate that statins may be beneficial in treating rheumatoid arthritis. McCarey and colleagues studied the clinical effects of atorvastatin on patients with rheumatoid arthritis in a double-blind, random-ized, placebo-controlled trial.

One hundred and sixteen adults with continued active rheumatoid arthritis after at least three months of adequate disease-modifying antirheumatic drug therapy participated in the study. Active disease was defined as at least six swollen joints and at least two other features (six tender joints, 30 minutes or more of morning stiffness, or erythrocyte sedimentation rate [ESR] of 28 mm per hour or higher). Exclusion criteria included diabetes, elevated coronary heart disease risk, familial hypercholesterolemia, steroid intake of 10 mg or more per day, and significant renal insufficiency. Patients remained on all therapy for rheumatoid arthritis and other conditions throughout the study. After assessment, patients were randomized to receive 40 mg of atorvastatin or placebo. The primary outcome was change in the DAS28 scale, a validated composite disease activity score that incorporates ESR, visual analog score for pain, and number of swollen or tender joints. Additional outcomes included health assessment questionnaires, C-reactive protein, plasma lipids, and endothelial function markers. Physicians assessed patients after three and six months of therapy; evaluation included screening for changes in liver and kidney function.

The two groups were generally comparable on entry to the study, but pain scores and global assessments were slightly lower in the atorvastatin group. At six months, DAS28 was significantly reduced in the atorvastatin group compared with placebo. Thirty-one percent of the atorvastatin group achieved moderate or good DAS28 response com-pared with only 10 percent of the placebo group. The atorvastatin group also showed significant improvements in acute-phase reactants. Levels of C-reactive protein and ESR declined by 50 and 28 percent respectively in patients receiving atorvastatin compared with those receiving placebo. These results remained consistant after adjusting for all significant variables. Other indicators of disease activity, particularly the number of swollen joints, also improved during atorvastatin therapy. Very few adverse events occurred in either group. More atorvastatin patients completed the study than placebo patients (53 out of 58 compared with 45 out of 58, respectively). More placebo patients received intramuscular or intra- articular steriod injections during the study.

The authors conclude that atorvastatin was associated with a modestly beneficial but clinically useful effect in patients with rheumatoid arthritis. They speculate that statins provide vascular protective and adjunctive immune- modifying effects to disease-modifying antirheumatic drug therapy and could be effective in treating chronic inflammatory diseases.

McCarey DW, et al. Trial of atorvastatin in rheumatoid arthritis (TARA): double-blind, randomised placebo-con-trolled trial. Lancet June 19, 2004;363:2015-21.

COPYRIGHT 2005 American Academy of Family Physicians
COPYRIGHT 2005 Gale Group

Return to Rheumatoid arthritis
Home Contact Resources Exchange Links ebay