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Rheumatoid Arthritis


Normal joint versus joint with rheumatoid arthritis

Rheumatoid arthritis, RA, is an autoimmune disease affecting the connective tissues throughout the body. An autoimmune disease means the individual's antibodies in their blood mistakenly target their own body tissues. RA is characterized by chronic inflammation of the synovium which causes irreversible damage to the cartilage and joint capsule. There is generally muscle and bone atrophy and small erosions in the bone surrounding the involved joints. The image to the right demonstrates a normal joint with the intact cartilage surrounding the bone ends and normal synovium surrounding the joint. The lower image shows the thickening of the synovial membrane with the associated increase in joint fluid and bone erosions.

Common signs of rheumatoid arthritis include:

  • pain worse after immobility or rest
  • stiffness in the morning or after immobility ("morning stiffness")
  • stiffness and pain subside after joint "warms up"
  • pain worse after prolonged activity
  • swelling of small joints in both hands and/or both feet
  • symmetrical joint involvement (both hands or both feet have the same joints swollen)
  • nodular growth around the small joint in the hands and/or feet
  • fatigue, loss of energy, loss of appetitie, weight loss

In the foot, the metatarsal phalangeal joints are the most commonly affected joints. The image below show a diagram of the bones with the MPJs (metatarsal phalangeal joints) highlighted. The image to the right shows a severely affected foot of an individual with rheumatoid arthritis.

Metatarsal phalangeal joint pain in rheumatoid arthritis

SSevere deformity of the forefoot in an indvidiual with rheumatoid arthritis

There is no cure for rheumatoid arthritis and the goal of treatment is to reduce joint pain and inflammation, increase function and slow progression of the disease. A rheumatologist is a specialist in rheumatoid arthritis.