The Condition

Rheumatoid arthritis (RA) is a chronic autoimmune disease that primarily affects the joints, causing pain, swelling, and stiffness, but it can also impact other body systems. It affects larger joints in the knee and shoulder can also be affected and conditions will vary among individuals. The inflammation is often found in multiple joints, usually, yet not always occurring in a symmetrical pattern involving the destruction of bone and cartilage. Inflammation can create swollen, tender, stiff and often permanently deformed joints resulting in decreased movement and even loss of function. Fingers can exhibit a deviated, unnatural shape spanning towards the little finger (Figure 6). Typically, after waking, an increased stiffness can occur, identified as a prominent feature lasting as long as one hour.⁵⁰

Figure 6. Hands of a patient with Rheumatoid Arthritis.

Figure 6. Hands of a patient with Rheumatoid Arthritis.

RA is not like osteoarthritis, which is caused by extended wear on your joints. RA usually affects both sides of the body symmetrically, usually affecting hands, wrists. knees, and ankles. RA has been classified as a systemic disorder meaning the immune system attacks the body’s tissues leading to destruction and inflammation spreading to systems and tissues known as extra-articular conditions or “outside the joints” existing in approximately 15% of those diagnosed with RA.⁵⁴ Lymph nodes may become inflamed, and in aggressive systemic conditions nodules can occur under the skin and around joints, which are associated with a poor prognosis. It has been reported approximately 40% with RA also suffer with pericarditis affected by the inflammatory process.⁵¹ Those with RA have a 50% to 70% higher risk for cardiovascular disease than the general population, and are twice as likely to have a heart attack compared to those who don’t. ⁵⁶ Over one-third of deaths with RA were attributed to a cardiovascular condition identifying cardiovascular disease as a major factor in the increased mortality among those with RA.⁵⁴