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Arthritis literally means "inflammation of a joint". Since there are any number of factors that can cause inflammation
of a joint, there are many types of arthritis. Some examples of arthritis include osteoarthritis, psoriatic arthritis, rheumatoid
arthritis, and gout. Each of these may affect the patient differently and may have significantly different complications.
It is, therefore, very important to know the exact type or form or arthritis that you may be treating.
Rheumatoid
Arthritis (RA) is a chronic, systemic, inflammatory disease that chiefly affects the synovial membranes of multiple joints
in the body. Because the disease is systemic, there are many extra-articular features of the disease as well.
For
example, neuropathy, scleritis, lymphadenopathy, pericarditis, splenomegaly, arteritis, and rheumatoid nodules are frequent
components of the disease. In addition, the potential for involvement of the renal, pulmonary, and cardiovascular systems
exist. In most cases of RA, the patient has remissions and exacerbations of the symptoms. This means that there are periods
of time when the patient "feels good" and times when the patient "feels worse". There will likely be times that a patient
with RA "feels cured".
It is important to understand that there are very few patients that have complete remission
of the disease and it is essential that the RA patient does not stop the treatment program established by knowledgable health
care practitioners. Rarely does the disease "go away", although at times the symptoms might temporarily remit.
The
disease is considered an autoimmune disease that is acquired and in which genetic factors appear to play a role. The presence
of HLA-DR4 antibody in 70 percent of patients with RA lends support to the genetic predisposition to the disease.
Rheumatoid
Factor(s) (RF) are antibodies to IgG, and are present in 60-80 percent of adults with the disease. High titers of RF are usually
associated with more severe and active joint disease, greater systemic involvement, and a poorer prognosis for remission.
RA, as well as other autoimmune diseases, includes widespread immunologic and inflammatory alterations of connective tissue.
Because the autoimmune diseases share many clinical findings, making a differential diagnosis is often difficult. Although
the autoimmune disorders are considered acquired diseases, their causes usually cannot be determined.
The prevalence
of the disease is 1-2 percent of the general population and is found world-wide. Females with RA outnumber males by a 3:1
margin. Onset of the disease in adults is usually between the ages of 40 to 60 years, although it can occur at any age.
The
etiology of RA remains unknown. Metabolic and nutritional factors, the endocrine system, geographic, psychologic, and occupational
data have been extensively studied with no conclusive findings. It now appears that an unknown antigen initiates the autoimmune
response resulting in RA. There has been continuous suspicion of an infectious origin of the disease process, which has included
various bacteria and viruses, but without evidence of precipitating events.
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