Rheumatoid arthritis
An immune system that has begun attacking the lining of the joints. Treated early, the damage can largely be prevented, which is why we would rather see you sooner with a maybe than later with a certainty.
Reviewed by Mark Jaffe, MD · Board certified rheumatologist
Small joints of the hands and feet, usually on both sides
Morning stiffness that lasts more than an hour
Joint damage is largely preventable when treatment starts early
Dr. Jaffe, with Elizabeth for follow up and infusions
Overview
Rheumatoid arthritis is an autoimmune disease. The immune system, which should protect you, starts to attack the synovium, the thin lining inside the joints. The lining swells, the joint becomes painful and stiff, and over time the cartilage and bone can be damaged.
It can begin at any age and is more common in women. It is a lifelong condition, but with modern treatment most people keep working, moving and doing what they love.
Signs and symptoms
- Swelling and tenderness in several joints, often the knuckles, wrists and the balls of the feet
- Stiffness on waking that lasts more than an hour
- Symptoms on both sides of the body at the same time
- Fatigue and a general sense of being unwell
- Firm lumps under the skin near the elbows, called rheumatoid nodules
How it is diagnosed
There is no single test. Dr. Jaffe puts together your history, a careful joint examination, bloodwork such as rheumatoid factor and anti CCP antibodies, markers of inflammation, and imaging done here in the office. Most patients leave the first visit with a clear plan for confirming the diagnosis.
Treatment
Treatment has one goal: to quiet the immune attack before it damages the joints, and to keep it quiet.
Settle the flare
Short courses of anti inflammatory medication ease pain and swelling while longer acting treatment starts to work.
Protect the joints
Disease modifying medication such as methotrexate, and biologics when needed, slow or stop the immune attack.
Keep it quiet
Regular visits and bloodwork keep you safe on treatment. Some biologics are given in our own infusion suite.
Living with RA
Movement helps. Gentle, regular exercise keeps joints mobile and muscles strong, and many patients find water exercise or tai chi easiest on sore joints.
Stopping smoking improves how well treatment works. We will talk through what is realistic for you, at your pace.
Clinical researchPatients with RA may qualify for studies of new treatments.
Dr. Jaffe is a Principal Investigator with GNP Research. Taking part is voluntary, and declining changes nothing about your care.
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