Symptoms of Rheumatoid Arthritis:

• Symptoms first begin in the small joints of the fingers, wrists and feet, with warm, swollen and tender joints that are painful and difficult to move.
   
• Joints of both sides of the body (symmetrical) are typically affected.
   
• People with RA often experience fatigue, loss of appetite and low-grade fever.
   
• There is often stiffness in the morning that lasts for several hours or more.
   
• Nodules may form under the skin, often over the bony areas exposed to pressure (such as the elbows).
   
• Over time, damage to the cartilage and bone of the joints may lead to joint deformities.

Causes of Rheumatoid Arthritis:

• The cause of RA is not yet known.
   
• The immune system plays an important role in RA. Cells of the immune system invade joint tissues (the synovium), causing inflammation and over time damage the cartilage and bone.
   
• Genetic factors are thought to play a major role in RA.

Diagnosis of Rheumatoid Arthritis:

• Rheumatoid arthritis belongs to a family of forms of arthritis referred to as inflammatory arthropathies. Evaluation by a rheumatologist, an arthritis specialist, is recommended to distinguish RA from other members of this family.
   
• A diagnosis of rheumatoid arthritis can generally be made following a thorough medical history and physical examination, looking for distribution of joints affected, joint swelling, warmth and range of motion, as well as the presence of nodules under the skin.
   
• Imaging studies such as X-rays, sonograms or magnetic resonance imaging may be used to detect the degree of joint involvement or joint damage.
   
• A blood test can indicate the presence of an antibody called rheumatoid factor, which is found in 80 percent of people with RA; however, it can also be present in people who do not have RA.

Management of Rheumatoid Arthritis:

• The goals of treatment of RA are to reduce joint pain and swelling, relieve stiffness and prevent joint damage.
   
• Evaluation by a rheumatologist for the development and monitoring of a treatment plan is required in most people with RA.
   
• Treatment plans often include a combination of rest, exercise, joint protection, use of heat or cold to reduce pain and physical or occupational therapy.
   
• Drugs play a very important role in the treatment of RA.
   
• Many people with RA take nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce joint pain, stiffness and swelling.
   
• Low doses of corticosteroids such as prednisone may also be used to relieve joint pain, stiffness and swelling and to reduce the risk of joint swelling.
   
• People with RA are often treated with disease-modifying anti-rheumatic drugs (DMARDs), such as methotrexate or leflunomide.
   
• Biologic response modifiers (BRMs) are a class of drugs that inhibit proteins called cytokines which contribute to inflammation and joint damage in RA. BRMs must be injected under the skin or given as an infusion in to a vein.
   
• Many people with rheumatoid arthritis might consider surgery, including arthroscopic surgery and joint replacement surgery, as part of their treatment plan.

The Arthritis Foundation supports research, health education and government advocacy efforts to improve the lives of the nearly 46 million Americans with arthritis, the nation’s leading cause of disability. These services include:

• Number one ranked comprehensive arthritis Web site, www.arthritis.org
• Toll free information phone line: 1-800-283-7800
• Nearly 100 consumer educational brochures, booklets and books
• Arthritis Today, the Arthritis Foundation’s bi-monthly consumer magazine reaching 3.8 million readers per issue
• Water and land-based exercise classes, self-help courses and support groups
• Local chapter offices nationwide
• Physician referral lists
• Extensive funding of arthritis research grants at institutions nationwide
• Federal and state advocacy efforts to ensure rights and access to care for all people with arthritis