Rheumatoid arthritis: what kind of disease is it and why is it autoimmune

In the first month, the diagnosis of "rheumatoid arthritis" sounds louder than it actually is. It is a long-term condition with periods of flares and quiet spells. Let's calmly break it down: what kind of disease this is, why it is called autoimmune, and how it is recognized.

Rheumatoid arthritis: what kind of disease is it

According to medical guidelines, it is a long-term condition: joints hurt, swell, and become stiff — most often the hands, feet, and wrists. There are flares and quiet spells; a flare is hard to predict, but with treatment there are fewer of them. In a doctor's notes, the name is abbreviated to RA.

Unlike age-related osteoarthritis, rheumatoid arthritis attacks the inner lining of the joint and damages the tissue covering the ends of the bones. In developed countries it occurs in 0.5–1% of people, and among older adults up to 5%; each year 5 to 50 people per 100,000 are affected. Women are affected 3–5 times more often than men, and the average age of onset in women is 40–50 years.

Why rheumatoid arthritis is considered an autoimmune disease

The immune system is usually busy with infection. In rheumatoid arthritis, it mistakenly attacks the cells lining the joints, and they swell, become stiff, and hurt. Instead of recognizing bacteria and viruses, lymphocytes take on the body's own healthy cells.

What triggers the malfunction is unknown. Genes, environment (including smoking), and sex hormones are discussed. The risk is higher in women, in people with a family history of rheumatoid arthritis, in smokers, with obesity, and with gum and lung diseases. It is not transmitted from person to person: it is not an infection.

How the disease develops: pathogenesis in simple words

Immune changes may begin years before the first complaints. Then inflammation settles in the joints: the lining grows, pannus appears, and cartilage and adjacent bone are destroyed. In later stages, pannus growth may proceed independently of autoimmune mechanisms.

The first manifestation sometimes coincides with severe physical exertion, emotional shock, overwork, hormonal changes, or a previous infection. This is not the cause but a trigger against the background of an already prepared malfunction.

Rheumatoid polyarthritis: which joints and organs are involved

"Polyarthritis" means multiplicity: most often the hands, feet, and wrists are affected.

• Pain and stiffness on movement, worse in the morning or after immobility.
• Tenderness, redness and heat over the joint, swelling.
• Fatigue, fever, loss of appetite, firm nodules under the skin near the joints.
• Inflammation of the eyes, skin, heart, nerves, blood, lungs; carpal tunnel syndrome; higher risk of heart attack and stroke.

How rheumatoid arthritis is diagnosed

There is no single test, and at the start symptoms are few. The doctor asks about complaints and family history, examines the joints, looks for rash and nodules, listens to the chest, and orders blood tests and imaging — X-ray or ultrasound — to rule out other causes.

Blood is checked for ESR, rheumatoid factor, and platelet count; the most informative is considered the titer of antibodies to cyclic citrullinated peptide (anti-CCP). Sometimes synovial fluid is examined. Then the patient is referred to a rheumatologist.

Is rheumatoid arthritis contagious and when to see a doctor

No, it is not contagious: it is an autoimmune disease, not an infection. The term "infectious rheumatoid arthritis" does not exist in guidelines — an infection may be a trigger or a concomitant problem. A visit to the doctor should not be delayed: early diagnosis reduces the risk of joint damage. The disease shortens life by an average of 3–12 years, and the risk of heart disease is twice as high with it.

Rheumatoid arthritis itself is not a reason to call an ambulance. Call 103 or 112 for chest pain, sudden shortness of breath, facial asymmetry, weakness in an arm or leg, or speech impairment: the risk of heart attack, stroke, and lung damage is higher with this disease.

Go to the doctor with questions: which joints are affected and how severely, which tests have already been done and which are planned, how often disease activity is assessed, and what to do during a flare. This material is for reference and does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer