About Rheumatoid Arthritis

An example of a human condition caused by joint inflammation is rheumatoid arthritis. The illness differs from person to person and can harm the skin, lungs, eyes, heart, and blood vessels, among other body systems. The fact that an individual's own immune system attacks their own body tissues makes rheumatoid arthritis an autoimmune condition. As a result of interference with the joint linings, which causes deformity and borne erosion, the condition is characterized by an extremely painful swelling. Owing to the advanced medical research, it is possible to treat the condition today, however a greater number of the patients suffer physical disabilities. Additionally, the condition gets worse if a diagnosed is a smoker, is exposed to some negative environmental conditions, obese as well as has a family history of the disorder. The paper thus examines the pathophysiology of rheumatoid arthritis.

Pathophysiology of the Disease

Rheumatoid arthritis is an inflammatory condition characterized by joints destruction and synovitis. The disease is triggered by an individual's system leading to the interference with the linings of the joints and thus causing their ruination and borne deformation (McInnes & Schett, 2011). The real cause of the condition is yet to be discovered, however the researchers have stated that the auto systematic reaction is caused by either an external or internal body element. For example, factors such as trauma, infection or even smoking provokes an autoimmune reaction which then leads to a synovial hypertrophy (McInnes & Schett, 2011). Such a reaction eventually results in a joint inflammation and destruction of the body tissues, occasioning further injuries to the body, such as problems with the lungs, heart, skin, eyes and blood vessels. The condition is extremely severe in individuals with genetically susceptible mechanisms. Upon the trigger of the system, it should however be noted that the first reactions involve the endothelial cell activation and the synovial cell hyperplasia as part of the pathologic process which then continues to cause cartilage, uncontrolled inflammation, and bone destruction (McInnes & Schett, 2011). Immune system and genetic disorders have further been proven to be the catalysts of the condition. Some of the pathophysiological aspects involved in the development of the condition includes osteoclasts, mononuclear phagocytes, fibroblasts and CD4 T cells. The rheumatoid factors, on the other hand, emanate from the B cells which produces autoantibodies (McInnes & Schett, 2011). The ultimate development of the condition, however, results from the synovium proliferation and inflammation, occasioning the destruction of the cartilage, blood vessels, tendons, ligaments and bones.

The Causes of Rheumatoid Arthritis

While medical researchers have not been able to conclusively identify the cause of rheumatoid arthritis, most of them link the condition to systematic and genetic disorders. It is arguable whether an individual's genes may contribute to the disease development, but a more logical explanation of the same is that the susceptibility of these genes and the system of an individual to environmental factors, such as bacteria and viruses, speed up the occurrence of the disease (Gibofsky, 2012). The auto immune trigger is thus the most plausible explanation with regard to the cause of the disease. Medical researchers explain that, in most cases, human beings are meant to produce antibodies for fighting of the viruses and bacteria but the fact is not true in patients developing rheumatoid arthritis. For the latter, the antibodies produced do not attack viruses and bacteria, but are rather mistakenly sent by the immune system to the joint linings and thus resulting in the destruction of the surrounding joint tissues (Gibofsky, 2012). The inflammation of the synovia cells then follows, hence leading to the complete damage of the joints and bones if the condition is not urgently treated.

The triggering of the process has only been linked to the attack by bacteria and viruses, however no plausible theory has been put forward to explain the real cause of the disease. Several risk factors are proved to be related to the condition as explained below (Gibofsky, 2012). The first one is the genetic make-up of an individual as medical researchers have argued that in certain cases, Rheumatoid arthritis runs in the family and thus posing risk of inheritance of the same. Secondly, the condition has been claimed to be a hormonal problem owing to the fact that it is more prevalent in women compared to men (Gibofsky, 2012). Medical researchers have thus linked the same to the oestrogen hormone. Lastly, smoking has been asserted to increase the risk of contracting the disease as well.

Signs and Symptoms of Rheumatic Arthritis

The primary symptoms of rheumatic arthritis is joints pain and inflammation. The most affected joints in the body are those on the feet and hands and particularly the small ones. One defining symptom of the condition is pain, which gets particularly severe during the periods of inactivity and mornings. Another symptom is stiffness. Therefore, whenever the leg or the hand joints are affected by rheumatoid arthritis, they become very stiff and are often difficult for an individual to fold. The stiffness often lasts for more than 30 minutes, especially in the morning. Thirdly, a person suffering from this condition experiences a lot of redness, swelling and warmth. These symptoms arise due to the inflammation taking place in the joints of an individual, which is further responsible for making them hot and tender upon swelling. Rheumatoid nodules - which are very firm swellings - also develop under the joints in some patients.

While the above discussed signs and symptoms are very specific, there are also a wide range of those that are more general. These include sweating, poor sleeping, high body temperature or fever, poor appetite, tiredness and weight loss. Further, as a result of the inflammation, it is likely for an individual to endure chest pains in the event when lungs and heart are affected. Some patients also experience dry eyes, whenever the inflammation strikes them. Rheumatic arthritis is furthermore associated with the joints and the bones destruction in the long run if left untreated.

Diagnosis

Depending on the diagnosis report of the physician, two types of rheumatoid arthritis are recognized. These are seronegative and seropositive rheumatoid arthritis. During the medical examination, if a patient tests positive to the antibodies or the rheumatoid factors, it is said that an individual suffers from seropositive rheumatoid arthritis (Majithia & Geraci, 2007). On the other hand, when the condition is diagnosed without the presence of certain antibodies in the blood, a patient is said to have seronegative arthritis. The latter particularly frequently occurs when an individual has very low levels of antibodies (Majithia & Geraci, 2007). Patients diagnosed with this condition, however, may over time develop seropositive type after producing more antibodies.

The diagnosis of the disease by itself is not an easy task as there are a lot of conditions that lead to joint inflammations and joint pains. The first step of the process is therefore to visit a general physician, so as to have the joints examined with regard to swellings and their movement in connection with other symptoms, and determine whether an individual exhibits the symptoms (Majithia & Geraci, 2007). Upon ascertainment of the condition, the general physician may then refer the patient to a rheumatologist for further checkup. Some of the tests carried out by the physician include full blood count, erythrocyte sedimentation rate (CSR) and C - reactive protein (CRP), which are all blood tests. The reason as to why a doctor decides to conduct a full blood count tests is simply to rule out any presence of anemia (Majithia & Geraci, 2007). The latter condition also means that a patient is at a very high risk of having rheumatoid arthritis, although it is not always true for all cases.

The third diagnosis tool is the use of anti-CPP antibodies and rheumatoid factors. The anti- cyclic citrullinated peptide (anti -CPP) is as a rule one of the most accurate methods and thus any person who tests positive to the antibodies has a very high probability of suffering from rheumatoid arthritis (Majithia & Geraci, 2007). In the likely event that a patient is affirmative to both the anti-CPP test and the rheumatoid factors, then such a diagnosed is probably to suffer from mild arthritis which requires advanced treatment.

The last test for recognizing rheumatoid arthritis is joint imaging, where scans are done and examined to tell whether the condition is present (Majithia & Geraci, 2007).These tests include the use of x-rays, ultrasound and the magnetic resonance imaging. They are also to determine the extent of the inflammation.

Prognosis

Currently, about 1.5 million people in the United States suffer from rheumatoid arthritis, the major casualties being women and the old people above the age of sixty years (Schett & Gravallese, 2012). The quality of life of the diagnosed and their life expectancy thus depends on several factors such as age, positive test to the rheumatoid factor, and the general health condition of a patient. It is therefore recommended that a person with the condition is to undergo a proper treatment, to have a balanced diet, and to make proper lifestyle choices.

Diverse types of medicine are used for the treatment of the disease, which are often categorized into two broad types, namely anti-rheumatic drugs and biological therapies. For initial treatment, the DMARD tablets are always highly recommended (Schett & Gravallese, 2012). They include leflunomide, methotrexate, sulfasalazine and hydoxichloroquine (Schett & Gravallese, 2012). These drugs counter the inflammation reactions caused by the chemicals released by the immune system. The biological therapies, on the other hand, are modern ways of treating the condition. Some of the drugs belonging to this category include infliximab, etanercep, golimumab, adalimumab, abatacep and many more (Schett & Gravallese, 2012). They are given by way of injection and are combined with one of the DMARD drugs.

Conclusion

From the above discussion, it is plausible to conclude that rheumatoid arthritis is provoked by the body system of a human being triggered by an environmental factor such as a virus or a bacteria. The condition causes joint pains and swelling. Rheumatoid arthritis, diagnosed through physical examination, imaging such as x rays and scans, use of anti- CPP and conducting blood tests, may further be cured,. Lastly, the condition is treated by DMARD or biological drugs.

References

Gibofsky, A. (2012). Overview of epidemiology, pathophysiology, and diagnosis of rheumatoid arthritis. The American Journal of Managed Care, 18(13), S295-302.

Majithia, V., & Geraci, S.A. (2007). Rheumatoid arthritis: Diagnosis and management. The American Journal of Medicine, 120(11), 936-939.

McInnes, I.B., & Schett, G. (2011). The pathogenesis of rheumatoid arthritis. New England Journal of Medicine, 365(23), 2205-2219.

Schett, G., & Gravallese, E. (2012). Bone erosion in rheumatoid arthritis: Mechanisms, diagnosis and treatment. Nature Reviews Rheumatology, 8(11), 656-664.