Rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune disease primarily affecting the joints, especially the small joints, of the hands, wrists, and feet. It is characterized by inflammation, synovial membrane hypertrophy, pannus formation, joint destruction, pain, swelling, stiffness, particularly morning stiffness lasting more than an hour, and eventual loss of joint function. RA commonly presents as symmetric polyarthritis, and over time, can lead to joint deformities, such as ulnar deviation, swan neck deformity, and boutonnière deformity. Systemic features include fatigue, fever, weight loss, and malaise. The disease may also involve extra-articular manifestations, such as rheumatoid nodules, vasculitis, lung involvement, interstitial lung disease, pleuritis, pericarditis, ocular inflammation, scleritis, keratoconjunctivitis sicca, and neuropathy. Laboratory findings often include positive rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) antibodies, elevated ESR, elevated CRP, and anemia of chronic disease. Radiographic findings may show joint space narrowing, bony erosions, and periarticular osteopenia. Risk factors include genetic predisposition, HLA-DR4, HLA-DR1, female sex, smoking, and possible environmental triggers. Management involves disease-modifying antirheumatic drugs (DMARDs), methotrexate, biologics, TNF inhibitors, NSAIDs, glucocorticoids, and physical therapy to preserve joint function and quality of life. Early diagnosis and treatment are crucial to prevent irreversible joint damage and disability