Rheumatoid arthritis (RA) is an autoimmune and inflammatory disease where the immune system mistakenly attacks healthy cells in the body, leading to inflammation in affected body parts. This primarily affects the joints, often impacting many joints simultaneously, including those in the hands, wrists, and knees. Common symptoms of rheumatoid arthritis include joint stiffness, typically worse in the mornings or after periods of inactivity, fatigue, fever, and loss of appetite. Initially, early rheumatoid arthritis tends to affect smaller joints, particularly the joints connecting fingers to hands and toes to feet. As the disease progresses, symptoms often extend to the wrists and knees.
The concept of “early rheumatoid arthritis” has evolved significantly over the years, particularly since around 2015. In the early 1980s, having RA for less than two years constituted “early RA.” By 2010, newer criteria emerged, allowing for an earlier diagnosis of RA. Early diagnosis and treatment are crucial in slowing disease progression, highlighting the importance of early diagnosis and treatment.
Diagnosing rheumatoid arthritis can be challenging, especially in its early stages. The process typically involves taking a medical history, performing a physical exam, and conducting laboratory and imaging tests, such as x-rays or ultrasound. The difficulty in diagnosing RA in the early stages arises from the gradual development of the disease, with only a few symptoms present initially.
Treatment for rheumatoid arthritis is directed towards controlling synovitis (inflammation of the joint lining) and preventing joint damage. An early, aggressive approach to treatment is supported by the observation that joint damage, potentially leading to disability, begins early in the disease course. The goal of early aggressive treatment is to reduce or stop inflammation as quickly as possible, aiming for remission or other treatment goals.
For more information on rheumatoid arthritis, its symptoms, causes, and treatment options, visit the Mayo Clinic, Hospital for Special Surgery, Arthritis Foundation, and the Centers for Disease Control and Prevention (CDC).
