Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease of unknown cause, characterized by persistent symmetric polyarthritis (synovitis). Its hallmark feature is the inflammation of synovial joints, often leading to progressive damage. RA’s clinical presentation is heterogeneous and can begin at any age, with a peak incidence between 70 and 80 years. Women are more commonly affected than men, with a ratio of approximately two to one.
The initial clinical presentation of RA typically involves polyarticular disease with a gradual onset. However, some patients may experience acute onset with intermittent or migratory joint involvement or even monoarticular disease. The spectrum of RA presentation varies widely in terms of age of onset, degree of joint involvement, and severity. Delayed rheumatological referral can lead to less favorable long-term outcomes.
As a systemic autoimmune disease, RA not only affects joints but also presents with extra-articular involvement. Factors like genetic predisposition and environmental elements, including tobacco use, contribute to its development. The disease is also marked by the presence of autoantibodies targeting various molecules.
RA with symptom duration of fewer than six months is defined as early RA, and when symptoms persist for more than six months, it is considered established RA. No laboratory test is pathognomonic for RA, making its diagnosis a challenge. It often involves tendon and bursal involvement, especially in early disease stages.
The prevalence of RA is notably higher in females and predominantly observed in the elderly. Its management requires a comprehensive understanding of its clinical manifestations and therapeutic approaches.
For more detailed information on the clinical manifestations of rheumatoid arthritis, refer to UpToDate. Further insights into the diagnosis and management of early rheumatoid arthritis can be found at NCBI and RCP Journals. Comprehensive information is also available on Medscape, StatPearls – NCBI Bookshelf, Nature Reviews Disease Primers, Physiopedia, and PubMed. For an in-depth look at the pathological mechanisms of RA, consult Nature.
