What is rheumatoid arthritis?

What causes rheumatoid arthritis?

Which joints are affected by rheumatoid arthritis?

What are the signs and symptoms of rheumatoid arthritis?

How is rheumatoid arthritis diagnosed?

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What is rheumatoid arthritis?

Rheumatoid arthritis (RA) is a condition that makes the joints in your body become inflamed, causing pain and stiffness. It is the second most common form of arthritis.

It is known as an auto-immune condition, which means that the immune system, the body's natural self-defence system, gets confused and starts to attack your body's healthy tissues. In rheumatoid arthritis, the main way it does this is with inflammation in your joints.

At the moment there is no cure for RA but, over the years, treatment for RA has advanced significantly giving many people a better outlook.

With the right medication, many people living with RA lead near-to-normal, active lives. Research shows that the sooner treatment for RA begins, the more effective it is likely to be.  

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What causes rheumatoid arthritis?

The exact causes of RA are unknown. We know that it is an autoimmune disease - where the immune system aggressively targets the body's healthy tissues and joints rather than germs and viruses. When the immune system targets healthy joints, the joints can become stiff and inflamed and cause pain.

Research to date suggests that certain genes in our body, which play a part in the immune system, are linked with RA. Having these genes doesn't mean you will definitely get RA, but it means you might have a tendency to develop it.

Researchers now think that something must trigger RA in people who have a tendency to develop it. There is no real evidence yet as to what those triggers are, but it's thought they might include stress, an infection or virus, smoking or hormonal changes in your body.


Rheumatoid arthritis develops through a combination of genetic and environmental factors. Cigarette smoking is classed as an environmental factor and significantly increases the risk of developing the condition. Smoking can also weaken how well your medication works.

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Which joints are affected by rheumatoid arthritis?

RA varies a lot from person to person. It can affect almost any joint, the small joints of the fingers, thumbs, wrists, feet and ankles are most commonly affected. Knees and shoulders can also be affected and, less commonly, elbows, hips, neck, and other joints. Most people are affected in more than one joint. RA usually affects both sides of the body - not always at once, but usually within a short space of time.

In RA, your immune aggressively targets your joints and they become inflamed. The inflammation particularly affects;

- the synovial membrane (thin layer of tissue lining the inside of the joint)

- the tendon sheaths (tubes in which tendons move)

- the bursae (little sacs which hold fluid to coat the joint and help it move easily)

The joint swells and the inflamed tissues in the joint become stiff, painful and swollen. If the inflammation isn't tackled, it can damage the joints.

Much of this damage can happen in the first months and years of RA. This is why it is vital to get an early diagnosis so that you can get treatment before lasting damage is done.

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What are the early signs and symptoms of rheumatoid arthritis?

Although the symptoms of RA vary from person to person, the most common symptoms include;

- pain and swelling in the joints

- stiffness in the joints, particularly in the morning or after resting and lasting longer than 30 minutes

- redness or warmth in the joint

- inflammation around the tendons

Other symptoms;

- Fatigue (tiredness) and loss of energy

- Running a slight temperature

- A general feeling of being unwell, often described as like having the flu

- Loss of appetite

- Weight loss

- Anaemia

- Inflammation in other parts of the body such as the eyes

- Change in the way you walk and carry yourself

- Irritability

- Finding it difficult to do everyday tasks

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How is rheumatoid arthritis diagnosed?

There is no single test for RA and diagnosing it can be complicated. Your doctor will ask you about the difficulties you've been having, examine your joints and skin, and test your muscle strength. A physical exam will also look for signs such as warmth, swelling and pain in the joints.

It is important to be referred to a rheumatologist if you think you might have RA. Rheumatologists are experts in diagnosing and treating arthritis and other diseases that affect the joints, bones and muscles.

Early intervention is critical to a good outcome and to more effective treatment. The Irish Society of Rheumatology (ISR) recommends that a person going to their doctor with symptoms of RA should be seen within six weeks.

Blood Tests

It's likely your doctor will order a range of blood tests to help confirm RA. These blood tests will test for;

- Rheumatoid factor - an antibody found in 80% of people with RA. For many, though, this antibody is not present in the early stages

- Anti CCP - another antibody found in 60-70% of people with RA. If you test positive for this, you are more likely to develop RA

- Anaemia - your blood count

- CRP & ESR - blood protein and cell levels that measure how much inflammation or disease activity there is in your body

Blood tests are useful in diagnosing RA, however some people will have no signs of it in their blood results. Your doctor and healthcare team may talk about seropositive and seronegative arthritis.

Seropositive arthritis means your blood tests tested positive for CCP antibodies and a rheumatoid factor. This type tends to be more aggressive.

Seronegative arthritis means that your blood tests do not have a positive rheumatoid factor or show CCP antibodies. This type tends to be a little milder.

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For more detailed information about rheumatoid arthritis, flare management, fatigue, physical activity, healthy eating and more, contact the Arthritis Ireland Helpline 1890252846/01-6618188 [email protected]  

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