8/12/2019 Mar14 Arthritis Q&A

http://slidepdf.com/reader/full/mar14-arthritis-qa 1/2Page 18 — Healthy Cells Magazine — Peoria — March 2014

The Truth About Rheumatoid Arthritis(Part II of a Series)

Information provided by the National Institute of Arthritis and Musculoskeletal and Skin Diseases

R heumatoid arthritis (RA) is an inflammatory disease that causespain, swelling, stiffness, and loss of function in the joints. Itoccurs when the immune system, which normally defends the

body from invading organisms, turns its attack against the membranelining the joints.

What Causes Rheumatoid Arthritis? Scientists still do not know exactly what causes the immune sys-tem to turn against the body’s own tissues in rheumatoid arthritis, butresearch over the last few years has begun to piece together the fac-tors involved.

Genetic (inherited) factors: Scientists have discovered that certain genes known to play a role inthe immune system are associated with a tendency to develop rheuma-toid arthritis. For the genes that have been linked to rheumatoid arthri-tis, the frequency of the risky gene is only modestly higher in those withrheumatoid arthritis compared with healthy controls. In other words,individual genes by themselves confer only a small relative risk of dis-ease. Some people who have these particular genes never develop thedisease. These observations suggest that although a person’s geneticmakeup plays an important role in determining if he or she will developrheumatoid arthritis, it is not the only factor. What is clear, however, isthat more than one gene is involved in determining whether a persondevelops rheumatoid arthritis and how severe the disease will become.

Environmental factors: Many scientists think that something must occur to trigger the dis-ease process in people whose genetic makeup makes them suscep-tible to rheumatoid arthritis. A variety of factors have been suggested,but a specific agent has not been identified.

Other factors: Some scientists also think that a variety of hormonal factors may beinvolved. Women are more likely to develop rheumatoid arthritis thanmen. The disease may improve during pregnancy and flare after preg-nancy. Breast-feeding may also aggravate the disease. Contracep-tive use may increase a person’s likelihood of developing rheumatoidarthritis. This suggests hormones, or possibly deficiencies or changesin certain hormones, may promote the development of rheumatoid

arthritis in a genetically susceptible person who has been exposed to atriggering agent from the environment. Even though all the answers are not known, one thing is certain:rheumatoid arthritis develops as a result of an interaction of many fac-tors. Researchers are trying to understand these factors and how theywork together.

How is Rheumatoid Arthritis Diagnosed? Rheumatoid arthritis can be difficult to diagnose in its early stagesfor several reasons. First, there is no single test for the disease. In addi-tion, symptoms differ from person to person and can be more severe insome people than in others. Also, symptoms can be similar to those ofother types of arthritis and joint conditions, and it may take some time

arthritis q & a

8/12/2019 Mar14 Arthritis Q&A

http://slidepdf.com/reader/full/mar14-arthritis-qa 2/2March 2014 — Peoria — Healthy Cells Magazine — Page 19

for other conditions to be ruled out. Finally, the full range of symptomsdevelops over time, and only a few symptoms may be present in theearly stages. As a result, doctors use a variety of the following tools todiagnose the disease and to rule out other conditions:

Medical history:The doctor begins by asking the patient to describe the symptoms,

and when and how the condition started, as well as how the symptomshave changed over time. The doctor will also ask about any other medi-cal problems the patient and close family members have and about anymedications the patient is taking. Accurate answers to these questionscan help the doctor make a diagnosis and understand the impact thedisease has on the patient’s life.

Good communication between patient and doctor is especiallyimportant. For example, the patient’s description of pain, stiffness, andjoint function and how these change over time is critical to the doctor’sinitial assessment of the disease and how it changes over time.

Physical examination:The doctor will check the patient’s reflexes and general health,

including muscle strength. The doctor will also examine bothersomejoints and observe the patient’s ability to walk, bend, and carry outactivities of daily living. The doctor will also look at the skin for a rashand listen to the chest for signs of inflammation in the lungs.

Laboratory tests:A number of lab tests may be useful in confirming a diagnosis of

rheumatoid arthritis. Following are some of the more common ones:• Rheumatoid factor (RF): Rheumatoid factor is an antibody that is

present eventually in the blood of most people with rheumatoid arthri-tis. (An antibody is a special protein made by the immune system thatnormally helps fight foreign substances in the body.) Not all peoplewith rheumatoid arthritis test positive for rheumatoid factor, and somepeople test positive for rheumatoid factor, yet never develop the dis-ease. Rheumatoid factor also can be positive in some other diseases;

however, a positive RF in a person who has symptoms consistentwith those of rheumatoid arthritis can be useful in confirming a diag-nosis. Furthermore, high levels of rheumatoid factor are associatedwith more severe rheumatoid arthritis.

• Anti-CCP antibodies: This blood test detects antibodies to cycliccitrullinated peptide (anti-CCP). This test is positive in most peoplewith rheumatoid arthritis and can even be positive years before rheu-matoid arthritis symptoms develop. When used with the RF, this test’sresults are very useful in confirming a rheumatoid arthritis diagnosis.

• Others: Other common laboratory tests include a white blood cellcount, a blood test for anemia, which is common in rheumatoidarthritis; the erythrocyte sedimentation rate (often called the sed rate),which measures inflammation in the body; and C-reactive protein,another common test for inflammation that is useful both in making

a diagnosis and monitoring disease activity and response to anti-inflammatory therapy.

X-rays:X-rays are used to determine the degree of joint destruction. They

are not useful in the early stages of rheumatoid arthritis before bonedamage is evident; however, they may be used to rule out other causesof joint pain. They may also be used later to monitor the progression ofthe disease.

For more information about Rheumatoid Arthritis and other muscu-loskeletal health issues, visit www.niams.nih.gov. Join us next monthfor part III of the series on RA.

COURI CENTER for Gynecology and integrat ve Women’s Health

Healing starts here.

Not feeling well? Tired all the time?Can’t lose weight? Just not yourself?

You are not alone and we can help!

Dr. Couri designed TLC as anindividualized 15-week program based

on evidence-based medicine andspecialized lab work that is engrained

with the elements of Integrative Medicine.

If you experience any of thefollowing, we invite you to find out

more about the TLC Program:

Weight Gain • Stress • High CholesterolMood Swings • High Blood Sugar • Low/No EnergyPoor Eating Habits • Depression • Little/No LibidoFoggy Thinking • Anxiety • Joint Aches • Trouble

Sleeping • Menopause • High Blood PressureAllergies/Asthma • Type 2 Diabetes • Hormonal

Imbalance • Peri Menopause • Hot FlashesNight Sweats • No Desire to Exercise

Now Includes Food Sensitivity Testing