ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

1 On 1 With Rheumatoid Arthritis

Updated on September 20, 2015

Rheumatoid Arthritis Images

Rheumatoid Arthritis

When we think of the second word used in the naming of the disease ''Arthritis'', it might seem just as a mere inflammation of the joints. But what if its Rheumatic ? well, lets find out below.

Rheumatoid Arthritis

Rheumatoid arthritis is an auto-immune disorder in which receptors at the surface of The Synovium Known as the HLA-DR4 triggers the immune system which reacts by becoming hyperactive; this results into the immune system attacking the joints since it considers them as ''foreign bodies''. The process starts when the leucocytes gets attracted to the immune complexes of IgM(rheumatoid factor) and IgG.

NOTE: The two immunoglobulins; IgM and IgG fuse or come together since IgM is an antagonist to Fc Region or the (Fragment Crystallisable Region) of the IgG hence forming a complex in the process of fusing to attack the region. This process begins to form deposits over the Synovium and around the joints due to their reaction.

Once this is achieved, the leucocytes which adhere to the surface of the immune complexes start ingesting fibrin and the immune complexes formed as deposits. The leucocytes further release lysosomal enzymes that cause acute inflammatory response and tissue necrosis as well as inflammatory mediation.(IL-1, IL-6 and TNF(alpha).

The chondrocytes then respond to stimulation by the TNF, IL-1, IL-6 and other inflammatory Mediators causing then Chondrocyte cells to become activated and produce more metalloproteinase which lead to Cartilage damage. The synovium then becomes hypertrophied (Pannus) granular formations that were earlier blood vessels and tissue indicating initial hyperplasia and infiltration by plasma cells and Lymphocytes.

This process recurs overtime and when uncontrolled, the inflammatory process glides into a Chronic level.


Rheumatoid Arthritis diagnosis is based mostly on clinical imaging such as X-rays and CT scans which are more accurate. Pathognomonic types of diagnosis is NEVER used because the finding are never accurate reason being, the signs that may seem as major symptoms suggestive of Rheumatoid Arthritis; also manifests themselves in other diseases such as Arthritis and other Auto-immune disorders such as Systemic Erythematous Lupus Disease.

Other diagnostic methods Include:

  • Detection of elevated levels of Rheumatoid Factor(IgM) in the blood plasma or serum. (The higher the concentration the more severe the Inflammation is) It is produced by the plasma cell as an antibody against the Fc Region of IgG which is produced during (RA).
  • Elevated levels of Interleukins-1 in the Synovial Fluid.

If the patient has only one inflamed joint and Rheumatoid arthritis is suspected then the best diagnostic measure to take would be analysing the patient's synovial fluid from the Inflamed Joint and check for elevated WBC's (5,000-50,000)

Overview of the Signs and Symptoms Of the disease

Here is a pneumonic for remembering how the signs and symptoms manifests. {S.L.I.C.E}

S= Systemic; Patients have history of fatigue, malaise, nausea, weakness prior to onset of joint pain. Multiple Systemic complications including; ACD(anaemia of chronic disease), Felty's syndrome; which is a combination of rheumatoid arthritis, splenomegaly and neutropenia, Bakers cysts are also notable.

L= Location; Primarily affects the hands especially the proximal interphalangeal joints sparing the distal interphalangeal joints: Affects shoulders, hips, knees but not lower back because it is usually symmetrically distributed.

I= Inflammation; Prominent or swollen joints, erythemous(reddish) joints that are often warm.

C= Chronicity; Chronic, progressive, pain is usually worst in the morning.

E= Evidence of trauma?; No trauma incurred usually.

Things to note about Felty's Syndrome mentioned above

  • It is rare and it is formed of a triad of three diseases or rather conditions I.e. Rheumatoid Arthritis, Neutropenia and Splenomegaly
  • Patients who develop infection and with Felty's Syndrome has to be treated with antibiotics whether the infecting agents possess Gram(-) or Gram(+) rods.

Management of Rheumatoid Arthritis

Firstly, we have to understand that there is not yet an exact known cause found for RA, its treatment or prevention. The only way to deal with it is through its management. The following are some of the common remedies both medical and natural in dealing with Rheumatoid arthritis or rather reducing your chances of contracting it later in life especially in the 40's.

  • Quit Smoking if you are a Smoker
  • Exercising frequently helps a lot to reduce the pain and generally keeping fit helps you for the present and for the future on health basis.
  • If you are already suffering from the disease; you should keep taking the Disease Modifying anti-rheumatic Drugs(D.M.A.R.D) drugs that helps to ease away the pain by blocking away the chemicals that the immune system releases when activated to attack the joints. Other anti inflammatory Drugs such as Acetaminophen or Ibuprofen could be administered during the acute stage of the disease.
  • Nowadays a recombinant human interleukin-1Ra can be administered which is also a D.M.A.R.D to help ease the pain. It is sometimes combined with Methotrexate and taken alongside some corticosteroids. Other D.M.A.R.Ds include leflunomide, hydroxychloroquine and sulfasalazine.
  • Biological agents especially T.N.F (Tumor Necrotic Factor) alpha administered as inhibitors greatly reduce inflammation. NOTE; Before starting your patient on any biological agent you must first do a P.P.D(Purified Protein Derivative) is a type of skin test used to rule out or test for Latent T.B.

NOTE: We rule out Latent TB before we administer Biological agent drugs to prevent Immunosuppression which can be fatal overtime.

NOTE: Administration of certain drugs such as Methotrexate can cause hepatic fibrosis and in this case patients should be brought in after 1-2 months for a Comprehensive Metabolic Panel check where they check your Blood parameters and other tests like Liver and Kidney functions.

NOTE: Newly diagnosed patients may be treated with an initial dosage of Corticosteroid(prednisone) since Methotrexate and Biological Agents take approximately a month to show effect and reduce symptoms.

NOTE: The drug hydroxychloroquine can have some adverse effects on the patients such as retinopathy; so a doctor should use this in great moderation or stay way clear from using it.

Facts To Note About Rheumatoid Arthritis

1.Mostly the pain is worse during morning times when one wakes up.Mostly affects women more than men in a ration of 3:5 basis

2.More common especially to people of the Caucasian descent than The Blacks.

3.The disease has two main Components: Immunologic Reactions and Degradative Enzymes

4. Carpal Turner syndrome is often seen in Rheumatoid Arthritis and in this case the patient should be treated carefully by casting and immobilization or else they will develop Atlanto-Axial Subluxation which causes Infringement around the C1 and C2 which can result into paraesthesia and anaesthesia of hand and foot. If a patient comes with hand and foot paraesthesia, Put then on a stretcher with a C-spine Collar position holder to the neck to avoid Movements that may cause Further complications.

Shriya Napoleon Fernandes


Raynold Grahams Omondi


Video On Rheumatoid Arthritis.

Deeper Insight on Rheumatoid Arthritis


    0 of 8192 characters used
    Post Comment

    • RaynoldGrahamsooo profile imageAUTHOR

      Raynold Grahams Omondi 

      3 years ago from Luton, UK, England.

      Hey I am deeply sorry to hear that..But am hopeful that one day a solution of this will be found for this.. Am positive that there will be a breakthrough so let us keep Hoping.

    • peachpurple profile image


      3 years ago from Home Sweet Home

      That is a scary disease. My mom in law hand and feet are bound and crooked too.


    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at:

    Show Details
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the or domains, for performance and efficiency reasons. (Privacy Policy)
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)