Rheumatoid Arthritis: Diagnosis And Treatment

Introduction

One of the commonly diagnosed inflammatory arthritis, rheumatoid arthritis is characterized by definite swelling of at least one joint, which happens due to underlying bony erosions and cartilage destruction. Older age, smoking, and a family history of the disease are commonly associated with increased risk factors for developing rheumatoid arthritis.

So rheumatoid arthritis include stiff joints, swelling, fatigue, flu-like symptoms, and loss of range of motions such as the inability to reach out things within reach. With a lifetime prevalence of 1% worldwide, the onset of this disease could lead to significant disability in individuals. It is, therefore, always advisable to get an early detection to avoid an increased likelihood of the severity of the disease.

Rheumatoid Arthritis Diagnosis

Rheumatoid arthritis could be challenging to diagnose, especially during its early stages as it shares similarities with signs and symptoms of many other diseases and other forms of arthritis. In a typical diagnosis, your doctor will do the preliminary checking of your joints for specific swelling or redness. In fact, your doctor might even ask you to demonstrate your reflexes or muscle strength. The chances of diagnosis of rheumatoid arthritis increase if many smaller joints are involved.

Blood Tests

Unlike other diseases, there is no specific blood test to diagnose rheumatoid arthritis. The standard blood tests look for an elevated sedimentation rate of erythrocyte (ESR) or C- reactive protein (CRP). In fact, patients having inflammatory arthritis with the presence of rheumatoid factor or anti-citrullinated protein antibody stand more chances of being diagnosed as having rheumatoid arthritis. The indication of the existence of either of these inflammatory process in your blood test reports suggests a diagnosis of rheumatoid arthritis.

Imaging Testing

Apart from blood tests, your doctor may suggest you get X-rays to gain better insight into the progression of your arthritis over a period. An MRI and ultrasound tests could better judge the severity and the complexity of the disease in your body. Therefore, your doctor may recommend these tests as well, especially if you are already diagnosed with this disease.

The management of rheumatoid arthritis typically requires long-term treatment to control the progression of the disease. However, patients may become apprehensive about the potential side effects of medications, leading them to discontinue treatment, which can exacerbate their condition. It’s crucial for patients to discuss their concerns with their doctor and ideally seek advice and treatment from a specialist who holds DM in Rheumatology.

Dr. Arpit Verma, MBBS, MD (Pharmacology)

Rheumatoid Arthritis Treatment

Even though there is no particular treatment for rheumatoid arthritis, the advancement in clinical science suggests that early detection and timely treatment of this disease with disease-modifying antirheumatic drugs (DMARDs) could lead to better prognosis and remission of symptoms.

Medications

The kind of medications that one is prescribed is highly dependent on the severity and the timeline of the symptoms. Some of the primary medications used for the treatment of rheumatoid arthritis include- nonsteroidal anti-inflammatory drugs (NSAIDs) for the reduction in pain and inflammation, steroids for slow joint damage, disease-modifying antirheumatic drugs (DMARDs) for the slow progression of symptoms, and reducing the chances of permanent joints damage. Also, inform your doctor if you have any history of allergy to medicines (if experienced in the past).

These drugs mostly work on the target immune system responsible for inflammation that leads to joint and tissue damage. However, they also point to specific side effects and increased risk of other infections. Therefore, it is recommended to use prescribed medications under the supervision of your doctor.

After a thorough history and clinical examination, your doctor may ask you to undergo an MRI scan to diagnose the disease and understand the progress.

Dr. Ashish, M.B.B.S., M.D. in Clinical Pharmacology and Toxicology

Physiotherapy

Sometimes, doctors may advise you to consult a physiotherapist or an occupational therapist to help you with basic exercises to keep your joints flexible and lower the risk of more wear and tear of joints tissue.

Surgery

In case medications and physiotherapy don’t work, your doctor may ask you to consider surgery for damaged joints. Surgery is the best suitable option to correct joint deformities and pain reduction if medications are not much of a success.  Some of the commonly used surgical procedures for rheumatoid arthritis involve synovectomy (for removal of the inflamed lining of joints), tendon repair surgery, joint fusion surgery, and total joint replacement (which consists of the insertion of the prosthesis).

It is always recommended to discuss the benefits and risks of surgery before undergoing such a procedure.

Even though many patients encounter side effects on antirheumatic drugs they may not just decrease the pain and inflammation, they may also be able to reduce or prevent joint damage, and to preserve the structure and function of the joints.

Dr. Ashish, M.B.B.S., M.D. in Clinical Pharmacology and Toxicology

Effective treatment of Rheumatoid Arthritis is highly dependent on how early it is detected. Therefore, if you experience any of the symptoms such as swelling, inflammation, fatigue, or any of the signs above, it is imperative that you reach out to your doctor and talk about the treatment plan to combat this disease as early as possible.

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