Understanding Rheumatoid Arthritis (RA): Diagnosis, Risk Factors & Effects - A Nurse's Guide

What is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is an autoimmune condition. In other words, the immune system that protects your body from disease is somehow triggered and attacks the lining of your joints. Your body cannot fight off this condition because the system that should ward off the disease has been harmed.

RA usually becomes chronic and can lead to warmth, pain, and joint redness. RA commonly affects both sides of the body, so if your left knee is affected, so will your right.

RA may have flare-ups if you have a lot of emotional or physical stress. Other things can make it more active, such as cigarette smoking or viral infections. 

How is Rheumatoid Arthritis Diagnosed?

When your primary doctor thinks that you may have RA, they usually refer you to a rheumatologist, a doctor who specializes in arthritis. Rheumatologists perform a physical exam and ask about your medical history and symptoms related to arthritis. 

The rheumatologist will order blood tests to look for inflammation and antibodies (proteins in the blood). They may also order X-rays, CT, and MRI scans to look for signs that your joints are wearing down, especially at the ends of your bones.

For someone to be diagnosed with RA, your testing results should include the following:

• Inflammation (heat, redness, irritation) in two or more of your large joints (hips, knees, ankles, shoulders, and elbows)

• Inflammation in smaller joints

• Abnormal blood testing 

• Your symptoms are lasting for more than six weeks

The rheumatologist will talk with you about treatment options. There are many medications and self-care methods of treatment. 

Who Can Get Rheumatoid Arthritis? 

RA may develop in anyone, even children. 

These factors can make you more susceptible to RA:

• Your age - RA is most often seen in middle-aged adults.

• Your sex - Women are more likely to get RA than men. Hormonal changes may play a role.

• Obesity - Overweight people may have a higher risk and be more limited in how much they can improve their symptoms without losing weight. 

• Genes/Family History - If someone in your family has RA.

• Smoking - Those who smoke for a long time are more at risk, and if they continue to smoke, RA can be more severe.

• Lung diseases - Those with respiratory issues might see RA develop more often.

• Gum Disease - Those who have this may see RA develop.

What Are Other Health Effects Seen in Rheumatoid Arthritis?

RA can affect your body in many ways, not just your joints. Other medical issues that can happen because you have RA:

• Skin - dryness, red patches (Psoriatic Arthritis)

• Eyes - dryness

• Heart - increased risk of hardening of the arteries and an inflamed sac around it.

• Lungs - shortness of breath because of inflamed and scarred lung tissues

• Nerves - the inflamed tissues in the joint affected can cause pressure on the nerves near it.

• Saliva glands - less saliva leads to a dry mouth.

• Blood vessels - low red blood cells, otherwise known as anemia

• Bone marrow - may be affected as the bones can be shifted into awkward positions when you have inflamed joints. 

Key Points to Remember

• Rheumatoid arthritis can be a destructive disease. Getting diagnosed within the first six months after symptoms occur can be a huge factor in fighting the condition of RA.

• RA is not presently curable, but the symptoms can be treated, which should limit the damage to your joints.

• Proper treatment can minimize RA's effects when you make a plan with your rheumatologist and follow it well.

Be a Part of the Solution

There are ongoing research studies on rheumatoid arthritis.

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