Rheumatoid arthritis is a chronic inflammatory disease that  affects the small joints in hands and feet. Other joint may be affected also when the disease progress. The disease can be presented like oligoarticular, that means that less than 3 joints are involved , monoarticular, with only one joint affected, this is usually when the diseased is diagnosed early, and poliarticular, when more that 4 joints are involved.  Rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.
Rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues, it is know as autoimmune disease. In addition to causing joint problems, rheumatoid arthritis sometimes can affect other organs of the body — such as the skin, eyes, lungs, heart and blood vessels.
Although rheumatoid arthritis can occur at any age, it usually begins after age 40. The disease is more common in women but men can have it also.
Before, the treatment focused on controlling symptoms and preventing joint damage, With the development of more treatments the goal change , now is to stop the development of the disease , control it and eventually send the patient to an specific status of no, pain, no swelling, laboratory findings normal and no medications, that is called remission. The Remission status is more factible if the disease is diagnosed early. All the clinics in Europe and Some in Mexico make early diagnosis clinics and treatments, then our patients go to remission very often.

Signs and symptoms of rheumatoid arthritis may include:
    •    Tender, warm, swollen joints
    •    Morning stiffness that may last for hours
    •    Firm bumps of tissue under the skin on your arms (rheumatoid nodules)this is only in late diseases
    •    Fatigue, fever and weight loss
Early rheumatoid arthritis tends to affect your smaller joints first — particularly the joints that attach your fingers to your hands and your toes to your feet.
As the disease progresses, symptoms often spread to the wrists, knees, ankles, elbows, hips and shoulders. In most cases, symptoms occur in the same joints on both sides of your body.
Rheumatoid arthritis signs and symptoms may vary in severity and may even come and go. Periods of increased disease activity, called flares, alternate with periods of relative remission — when the swelling and pain fade or disappear. Over time, rheumatoid arthritis can cause joints to deform and shift out of place.
It is important to know that eventually if the disease is well controlled there are less possibility to have flares, and over the time with a good treatment the patient will not have any deformity.  In some patients during the treatment when we reduce the swelling and control the disease , the deformity can be reverse. 
When to see a doctor
Make an appointment with your doctor if you have persistent discomfort and swelling in your joints.



 

You would associate joint pain with a woman in her middle age. But what if a young girl  in their 20s gets it? Or a child? Well, it is not  uncommon. Rheumatoid arthritis, which is a prevalent disease, attacks on any age  And it would be quite justified to get worried about it.

Rheumatoid arthritis , an auto-immune disease causing the lining in the joints to become inflamed,  is a chronic illness and requires  treatment for several years. If the disease is not treated, it could damage the joints and make them  deformed some times permanently. This inflammatory joint disease could attack  child, men or women an any age. Studies have shown that is more common in some families than others.

Rheumatoid arthritis attacks multiple joints at a time, on both sides of the body, affecting  the large and small joints in the limbs. The joints get painful,  swell up and the movement becomes restrictive.
Rheumatoid arthritis persists and increases in intensity with time. In addition, people who suffer from this disease tend to feel sick, sometimes develop fever and get fatigued easily.

The disease afflicts nearly one per cent of the urban population according the estimations . But in five years, in up to one-third of them the disease gets controlled. The rest could take 10-15 years to come out clean, nevetherless the disease would have destroyed some of the joints. Treatment for the disease ... effective one...  when it is active is imperative .
This desease  is also a silent killer as it exposes the person to other life-threatening diseases, like heart problems and lymph node cancer.

However, treatment has become advanced now and people with rheumatoid arthritis can be saved from a life of pain and immobility. There are safer and more effective medicines now to treat the disease and deal with the symptoms. Protein-based drugs also work. There are also surgical options to clean the inflamed joint linings. And if the joint has been severely damaged, one now has the option of going in for joint replacement.

Awareness about rheumatoid arthritis is growing but there is still a lot of ignorance among the general public and medical practitioners. Cases of inappropriate treatment by doctors who mistake the disease are not uncommon. But now that credible information is easily available, awareness about this debilitating disease is bound to increase.

Dra Irma Rosales  is a Consultant rheumatologist at Clinica Reumatológica Vida, San José del Cabo, México.