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January 07, 2009  
EDUCATION CENTER: Shoulder Conditions
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  • Rheumatoid Arthritis

    Quick Reference

    Reviewed by Dr. Ken Alleyne

    Rheumatoid arthritis (RA) is also known as inflammatory arthritis. It causes the same pain from joint destruction that osteoarthritis produces but by a different mechanism. RA is thought to result from an autoimmune reaction. In a complex series of interactions, the tissues surrounding the joints become inflamed and erode into the joints. It is a systemic disease, meaning it can cause many other problems with areas of the body both in and outside of joints. Typical deformities can often be seen in other parts of the body, especially the hands.

    Detailed Description

    Symptoms

    • Shoulder, neck, foot, ankle and/or knee pain, often bilateral (similar pain in joints on both sides of body)
    • Pain in fingers, toes, hip, ankle, wrist, shoulder, even when resting
    • Pain increases with activity
    • Pain increases with changes in weather (especially cold)
    • Morning stiffness lasting an hour or more
    • Joints red, warm, swollen, or tender when touched
    • Thickening around joints
    • No fever/low-grade fever
    • Nodules under the skin, especially around elbow, on fingers (20 to 40 percent of patients)— firm, but not painful
    • General fatigue


    Causes and Risk Factors

    Causes

    The exact cause is unknown. Rheumatoid arthritis is suspected to be autoimmune or may be set in motion by viral or bacterial infection.

    Risk Factors


    • Family history (of arthritis or autoimmune diseases)
    • Genetic defects (autoimmune system)
    • Female gender (usually between the ages of 20 to 50
    • Native American ethnicity

    Treatment

    Immediate Action:

    • Keep doing as much of your normal routine as possible.
    • Start slowly and try to exercise more and more to keep your joints flexible and strong. Consult your doctor for recommended amount of exercise.
    • Schedule daily rest periods and sleep well to keep from getting overtired.
    • If the joint is not warm or swollen, use heat to relieve the pain. Hot soaks, heat lamps, or whirlpool treatments may help.

    See Your Doctor:

    If: you have the symptoms of rheumatoid arthritis; you have a fever during treatment; symptoms appear in joints where you didn’t have them before or other unexplained symptoms develop.

    To: possibly obtain splints for pain control; get physical therapy; consider whether surgery is necessary.

    Procedures

    The doctor may order X Rays, blood tests, or tests of synovial fluid in order to diagnose the condition.

    For advanced cases, surgery may be necessary.

    Surgical Procedures may include synovectomy, total shoulder replacement, or arthroplasty. The severity varies greatly and treatment is specific to each patient.

    Medications

    Possible medications include non-steroidal anti-inflammatory drugs (including aspirin and other salicilates); steroids; gold compounds; choloroquine or hydroxychloroquine; penicillamine; immunosuppressive drugs; cortisone injections.

    Prevention

    None known at this time. Protection and prevention are the mainstay of treatment.

    Last updated: 10-Oct-00

       
     
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