Rheumatoid Arthritis
Chronic autoimmune disease causing symmetric inflammation of multiple joints. Early diagnosis and disease-modifying therapy prevent the joint destruction that defined RA a generation ago.
What it is
Rheumatoid arthritis is a chronic autoimmune disease in which the immune system attacks the synovial lining of joints, causing inflammation, pain and progressive joint destruction. Unlike osteoarthritis, RA typically affects small joints symmetrically — hands, wrists, feet — with morning stiffness lasting more than an hour. It also causes systemic features (fatigue, low-grade fever, weight loss, anaemia of chronic disease) and can involve other organs (lung, eye, blood vessels). The last two decades have transformed prognosis through early diagnosis and biologic disease-modifying therapy, but window-of-opportunity matters: starting treatment within 12 weeks of symptom onset substantially improves long-term joint function.
Key lab markers
- Rheumatoid factor (RF) — present in 60–80% of patients.
- Anti-CCP antibodies — more specific than RF; predict erosive disease.
- CRP and ESR — track inflammatory activity.
- Hemoglobin — anaemia of chronic disease is common.
- Joint imaging — ultrasound or MRI detects synovitis before X-ray erosions appear.
- Vitamin D — commonly deficient; supplementation supports bone health on chronic glucocorticoid.
Symptoms
- Symmetric joint pain and swelling (hands, wrists, feet first)
- Morning stiffness lasting >1 hour
- Fatigue
- Low-grade fever
- Subcutaneous nodules
- Eye inflammation (scleritis, episcleritis)
- Lung involvement (interstitial lung disease)
- Weight loss
When to discuss with a doctor
Symmetric small-joint pain with morning stiffness lasting more than an hour, especially with swelling, warrants prompt rheumatology referral. Time matters — starting disease-modifying anti-rheumatic drugs within 12 weeks of symptom onset substantially improves long-term outcomes. Methotrexate is first-line; biologics are added when needed.