Rheumatoid arthritis(RA) is the most common type of autoimmune arthritis. It is triggered by a faulty immune system(the body’s defence system) and affects the wrist and small joints of the hand, including the knuckles and the middle joints of the fingers. Treatments have improved greatly and help many of those affected. For most people with RA, early treatment can control join pain and swelling, and lessen joint damage. Perform low-impact aerobic exercises such as walking, and exercises to boost muscle strength. This will improve your overall health and reduce pressure on your joints. People who receive early treatment are more likely to feel better sooner and lead an active life. They are also less likely to have the type of joint damage that leads to joint replacement. Expertise is vital to make an early diagnosis of RA and to rule out diseases that mimic RA. Rheumatologists are experts in RA and can design a customized treatment plan that is best for you.

1. RHEUMATOID
ARTHRITIS
SIJO.A

2. CONTENTS
 INTRODUCTION
 RHEUMATOID ARTHRITIS
 CAUSES
 SYMPTOMS
 DIAGNOSIS
 TREATMENT
 RISK FACTOR
 LIVING WITH RHEUMATOID ARTHRITIS
 CONCLUSION

3. INTRODUCTION
 Rheumatoid arthritis(RA) is the most common type of autoimmune arthritis. It is triggered by a faulty immune
system(the body’s defence system) and affects the wrist and small joints of the hand, including the knuckles and
the middle joints of the fingers.
 Treatments have improved greatly and help many of those affected. For most people with RA, early treatment can
control join pain and swelling, and lessen joint damage.
 Perform low-impact aerobic exercises such as walking, and exercises to boost muscle strength. This will improve
your overall health and reduce pressure on your joints.
 People who receive early treatment are more likely to feel better sooner and lead an active life. They are also less
likely to have the type of joint damage that leads to joint replacement.
 Expertise is vital to make an early diagnosis of RA and to rule out diseases that mimic RA. Rheumatologists are
experts in RA and can design a customized treatment plan that is best for you.

4. RHEUMATOID ARTHRITIS
 RA is the most common form of autoimmune arthritis, affecting more than 1.3 million Americans. Of these, 75% are
women. In fact, 1-3% of women may get rheumatoid arthritis in their lifetime. RA can start at any age.
 RA is chronic(long-term) disease that causes pain,stiffness,swelling and limited motion and function of many joints.
While RA can affect any joint, the small joints in the hands and feet are tend to be involved most often.
Inflammation sometimes can affect organs such as eyes and lungs.
 The stiffness seen in active RA is most often worse in the morning. It may last one to two hours or even the whole
day. STIFFNESS IN THE MORNING IS A CLUE….

5. CAUSES
 RA is a autoimmune disease. This means that certain cells of the immune system do not work properly and start
attacking the healthy tissues– the joints in RA.
 The cause of RA is not known.
 In RA, the focus of the inflammation is in the synovium, the tissue that lines the joints.
 Immune cells release inflammation-causing chemicals. These chemicals can damage cartilage(the tissue that
cushions between the joints) and bones.
 Sometimes, genes that affect the immune system may make some people more prone to RA.

6. ILLUSTRATION OF JOINT WITH RHEUMATOID ARTHRITIS

7. SYMPTOMS
 Joint inflammation with pain,warmth and swelling.
 Joint stiffness, particularly in the morning or after period of inactivity.
 Fatigue
 Fever
 Joint pain
 Joint tenderness
 Joint redness,loss of joint range of motion
 Polyarthritis
 Limping
 Joint deformity
 Symmetric(both sides of body affected)
 Loss of joint function
 Anemia
 Dry mouth
 Nodule formation on joints
 Weight loss
 Difficulty in sleeping

8. RHEUMATOID NODULES ON FINGERS

9. RHEUMATOID NODULES ON ELBOW

10. DIAGNOSIS
 RA can be hard to detect because it may begin with subtle symptoms such as achy joints or a little stiffness in the morning. And many
other disease behave like RA.
 A Rheumatologist is a physician with the skill and knowledge to reach a correct diagnosis of RA and to make the most suitable treatment
plan.
 Diagnosis of RA depends on the symptoms and results of a physical exam such as warmth,swelling and pain in the joints.
 Some blood tests can also help confirm RA.
 Symptoms that help in diagnosis of RA include:-
• Anemia(a low red blood cell count)
• Rheumatoid factor(an antibody or blood protein,found in about 80% of patients with arthritis)
• Elevated erythrocyte sedimentation rate(a blood test that in most patients with RA confirms the amount of inflammation in the joints)
• Vasculitis(inflammation of blood vessels which can hamper blood supply to tissues)
• Felty syndrome(low white blood cell count; also linked to an enlarged spleen)
• Pericarditis(inflammation of the lining surrounding the heart)
• Pleuritis(inflammation of the lining of lungs)
• Sjogren’s syndrome(inflammation and damage of the glands of eyes and mouth; other parts of the body can also be affected)
 Other methods to diagnose RA include:-
• X-ray
• MRI
• Ultrasound scanning
• Blood tests

11. DOCTOR EXAMINING HANDS FOR RA

12. BLOOD TEST

13. X-RAY

14. TREATMENT
 There is no cure for RA. The goal of treatment is to lessen your symptoms and poor function.
 Doctors do this by starting proper medical therapy as soon as possible. No single treatment works for all patients.
 Good control of RA requires early diagnosis and sometimes aggressive treatment. Thus patients diagnosed with
RA should begin their treatment with Disease-modifying antirheumatic drugs, referred to as DMARDs. These
drugs not only relieve symptoms but also slow progression of the disease.
 Often, doctors prescribe DMARDs along with Non-steroidal anti-inflammatory drugs(NSAIDs) and low-dose
corticosteroids to lower swelling,pain and fever.
 Common DMARDs include Methotrexate(rheumatrex,trexall,otrexup,rasuvo), Leflunomide(arava),
Hydroxychloroquine(plaquenil), Sulfasalazine(azulfidine).
 Patients with more serious disease may need medications called Biologic response modifiers or Biologic agents.
They can target the parts of the immune system and the signals that lead to inflammation and joint and tissue
damage.
 FDA-approved drugs of this type include Abatacept(orencia), Adalimumab(humira), Anakinra(kineret),etc.

15. MEDICATIONS FOR RA

16. OTHER TREATMENTS
 Some people with RA get relief from using moist heat, acupuncture and relaxation.
 Supplements that have been shown to possibly help RA are fish oil, borage seed oil, etc.
 Supplements should be taken only after consulting with your doctor as they can cause side effects and may interact
with your medications.

17. ACUPUNCTURE TREATMENT

18. IS SURGERY AN OPTION?
 Doctor will suggest surgery for patients with a lot of joint damage or pain.
 Joint replacement(especially hips and knees) is the common type for people with RA.
 Other types of surgery include Arthroscopy(inserting a tube-like instrument into the joint to see and repair damage)
and tendon reconstruction.

19. RISK FACTORS
 Your likelihood of developing RA can be affected by the risk factors such as:-
• Gender : -- women develop RA at a higher rate than men.
• Age : -- RA can develop at any age, but most people begin to notice the symptoms between the ages of 49 and 60
years.
• Family history : -- You are at high risk of having RA if other family members have it.
• Smoking : -- cigarette smoking can increase your chances of developing RA.
• Excess weight : -- Excess weight stresses joints and increase the risk or chances of RA.
• Stress : -- Stress can intensify symptoms. Lack of sleep also contributes to this.

20. JUVENILE RHEUMATOID ARTHRITIS
 Juvenile arthritis is the most common type of arthritis in kids.
 Like adult RA, it causes joint inflammation,stiffness and damage. However, it can also affect the child’s growth.
 Juvenile RA is also known as Juvenile idiopathic(means cause unknown) arthritis.

21. LIVING WITH RHEUMATOID ARTHRITIS
 Research shows that people with RA, mainly those whose disease is not well controlled, have a higher risk for
heart disease and stroke.
 It is important to be physically active. But rest is helpful when a joint is inflamed or when you feel tired.At these
times, do gentle range-of-motion exercises. This will keep the joints flexible. When you feel better, do low-impact
exercises such as walking and exercises to boost muscle strength. This will improve your overall health and reduce
pressure on your joints.
 Maintaining proper diet is also very important for controlling RA.
 Applying cold to joints can numb pain and ease swelling; and heat can soothe aching muscles.
 Do stress reducing techniques like deep breathing exercises and meditation. Most people with RA need 8-10 hours
of sleep a night.
 A physical or occupational therapist can help you find which types of activities are best for you, and at what level or
pace you should do them.

23. CONCLUSION
 Rheumatoid arthritis is a autoimmune disease in which the immune system attacks the lining of the joints.
 Rheumatologist is an expert with skills and knowledge to identify RA and will provide best treatment plan for the
patient diagnosed with RA.
 Causes are not known.
 Symptoms include achy joints,joint stiffness,loss of joint function,anemia,joint inflammation,etc.
 Diagnosis can be done using blood tests, MRI, X-ray, ultrasound scanning, etc.
 There is no cure for RA. Treatments are done to lessen the symptoms.
 Risk factors include gender, age, family history, smoking, etc.
 Juvenile RA is the common type of arthritis in kids.

24. THANK YOU……!!!!!!