Rheumatoid Arthritis

Rheumatoid arthritis is a term for unpleasant chronic disease, which belongs among the group of autoimmune disorders. It is usually not life-threatening, but it may cause many complications and significantly dampen the patient’s life quality. Both sexes may be affected, but the disease is more common in women.


The actual cause of the disease is not fully known. The immune system turns against our own tissues and damages them. This autoimmune response is mediated by immune cells and so-called autoantibodies (antibodies targeting own tissues and organs). The typical autoantibody in rheumatoid arthritis is known as the rheumatoid factor. The reason of pathological immune response is not known, it is probably a consequence of certain genetic predisposition and a 


The disease can manifest in different ways. Classically, it causes gradual deterioration of patient’s problems with occasional bouts of rapid worsening. The majority of symptoms occur due to joint damage. The patient suffers from typical morning stiffness and pain of the joints that relatively quickly disappears during physical exercise. This is quite a good distinguishing symptom from the osteoarthritis as the symptoms in osteoarthritis get worse during exercise and disappear at rest. In addition to the stiffness, the joints may get swollen and tender. The most typically affected are small joints of hands such as the knuckles. Chronic inflammation may cause deformations of hands that begin to veer to the ulnar side.

Other possible symptoms may include fever, non-infectious pericarditis, Raynaud's phenomenon and others.


As in other autoimmune diseases, there is no prevention of the rheumatoid arthritis. We do not know the direct cause and so we have no protection.


There are precise diagnostic criteria, but this is a too difficult issue for laymen. Simply told, it is important to know the patient’s symptoms and family history (other autoimmune diseases in close relatives). Blood tests can confirm the ongoing inflammation process in the body (elevated sedimentation rate and CRP) and presence of the rheumatoid factor in patient’s serum. Affected joints can be examined by an X-ray.


The treatment falls fully into the competence of rheumatologists and I shall mention it only marginally. Regular physical exercise is advisable and in addition various anti-inflammatory drugs are used. The classic and probably best known drugs are the corticosteroids. Chronic usage of such drugs against rheumatic arthritis has, however, may side-effects. A relatively modern form of treatment is the biological therapy. In this issue, biological therapy means administration of special substances selectively dampening the immune system.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Contact: jiri.stefanek@seznam.cz
 Sources: basic text sources