Rheumatoid Arthritis

Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory multisystem disease of unknown etiology which primarily causes inflammation of synovial joints. It is a heterogeneous disease with a variable clinical course and outcome. The arthritis is typically symmetrical, involves the hands and feet, and may progress to involve numerous other larger joints in time. If untreated or inadequately treated, RA can cause erosion of cartilage and bone which leads to joint deformity and functional disability. In addition to the joints, RA may have numerous extra-articular features which may contribute to morbidity and sometimes mortality. In general, RA is a progressive disease, and some patients can have a very difficult course with rapid joint destruction, chronic pain, and poor response to therapy. Early diagnosis and aggressive management with disease-modifying therapy can alter the course of the disease and vastly improve outcomes. Studies on the pathophysiology of the disease and the role of T cells, B cells, cytokines, and other inflammatory mediators have led to the development of targeted therapies which have changed the horizon for patients diagnosed with RA.