Rheumatoid arthritis is painful swelling, usually of the smaller joints, together with the destruction of tissue around them. It most often begins in early adult life, between the ages of 30 and 40, and, although an attack may subside, it usually flares up again. The cause of this affliction remains unknown. There is a risk with rheumatoid arthritis of crippling or other physical deformities. In children, the condition is known as juvenile rheumatoid arthritis or Still’s Disease.
Clinical features of Rheumatoid Arthritis Onset may be sudden, with inflammation in different joints. More often, however, the onset is gradual with more and more joints becoming inflamed. Tenderness in the affected joints is the most telling physical manifestation. Joints become stiff and swollen, and corresponding joints on both sides of the body are often affected. The stiffness and swelling tend to be worse in the morning or after exercise. Nodules are frequently felt over joints or bones where they are near the skin surface. A person frequently feels unwell and easily becomes fatigued. Rashes and fevers can occur. Joints often become deformed because of damage to the surrounding tissue and because of shortening of tendons. Persons with an acute onset of the disorder display obvious symptoms – fever and considerable joint pain. Those with a milder form of rheumatoid arthritis complain more of stiffness and lethargy.
Treatment for rheumatoid arthritis Bed rest is often prescribed for short periods during the most acute stages of the disease. Anti–inflammatory drugs are an integral part of any long term treatment. Drug treatment usually consists of adequate dosages of aspirin or aspirin–like, anti–inflammatory drugs, such as indomethacin or sulindac. Other forms of drug treatment include injections of gold salts, D–penicillamine, and chloroquine.
Other forms of treatment are there for rheumatoid arthritis Various forms of orthopedic surgery may be performed on joints that have become seriously deformed but in which the active disease has ceased. Minor operations to relieve adhesions or to remove the inflamed synovial membrane (which lines the capsule of a joint and secretes lubricating fluid) may produce considerable improvement. Dramatic progress in replacement surgery now enables surgeons to insert plastic joints in fingers and carry out total joint replacement in the hips and knees. However, many patients cannot benefit from these procedures and may have to rely on specially designed appliances and equipment that can make everyday life simpler. These may include modified eating utensils and walking aids.
Do many patients become disabled? Most patients with rheumatoid arthritis maintain complete functioning of the joints. About 30% are left with some disability, despite appropriate treatment and about 5 to 10% are eventually severely disabled.