Rheumatology

Make an Appointment

Rheumatoid Arthritis

What is Rheumatoid Arthritis?

Rheumatoid Arthritis (RA) is a chronic autoimmune condition where your body’s immune system attacks its own joints.

Normally, white blood cells protect us from infections. In RA, these cells mistakenly enter the joints and attack:

  • Cartilage
  • Ligaments
  • Joint lining (synovium)

This leads to:

  • Swelling
  • Pain
  • Stiffness
  • Progressive joint damage and deformity
Who Gets RA?
  • Affects more women than men
  • Common onset: between ages 30–60
  • Can occur at any age
Which Joints Are Affected?

Most often:

  • Hands and fingers
  • Wrists, knees, feet
  • Hips, shoulders, elbows
  • Neck joints
How is RA Diagnosed?

When a patient has:

  • Joint pain and swelling
  • Early morning stiffness > 30 minutes
  • Multiple joints involved, especially small joints of the hands

To confirm the diagnosis your doctor will:

  1. Examine joints for swelling and tenderness
  2. Request blood tests:
    • Full Blood Count (FBC)
    • ESR / CRP (inflammation markers)
    • Rheumatoid Factor (RF)
    • Anti-CCP antibodies
  3. Request X-rays or ultrasound of affected joints
Why Early Treatment is Important

RA is like a fire in your joints – the longer it burns, the more damage it causes.

  • Cartilage cannot be rebuilt
  • Delayed treatment leads to: Joint destruction, Permanent deformity, Loss of function
  • Early treatment can control the disease and prevent long-term damage
Treatment Overview

1. Anti-Inflammatory Medications (NSAIDs)

  • Help reduce pain and swelling
  • Used temporarily to manage symptoms

2. Steroids (Corticosteroids)

  • Oral or injected into joints
  • Powerful short-term relief – very important as other drugs (DMARDs) take 2–3 months to act.
  • Used early to prevent joint damage

3. Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
These are the foundation of RA treatment. Stop the immune system from attacking joints. Must be started early

Common DMARDs include:

  • Methotrexate
  • Sulfasalazine
  • Leflunomide
  • Hydroxychloroquine

Possible side effects:

Risk of infection – While there is a small risk of infection, the benefits of controlling the disease and preventing joint damage and heart disease far outweigh the risks. It is strongly advised to continue medication with proper monitoring by your doctor.

Patients are advised to:

  • Report fevers, infections, ulcers, recent onset cough or rashes
  • Do regular blood tests to monitor drug safety as advised by the doctor
  • Don’t continue drugs beyond the specified period without review
  • Keep the date given for review to avoid side effects and adjust medications correctly

Advanced therapies when these fails are Biologics – Used when standard DMARDs don’t control the disease

  • Biologic injectables:
    • Adalimumab
    • Rituximab
  • JAK inhibitors (oral tablets):
    • Tofacitinib

Patients need TB and hepatitis screening before starting biologics – your doctor will do the necessary tests prior to commencing these.

Biologics are effective but more expensive – JAK inhibitors though expensive are cheaper than injectables

Lifestyle Advice & Joint Protection
  • Avoid overusing affected joints
  • Use splints for joint protection in early stages
  • Avoid:
    • Prolonged standing or walking
    • Repetitive gripping or lifting
  • Gentle range-of-motion exercises can help
  • Physical and occupational therapy may be recommended
When to Contact Your Doctor
  • Sudden increase in joint pain
  • New fever, mouth ulcers, or infections
  • Cough or breathing issues (RA may rarely affect the lungs)
  • Any side effects from medication
Final Message

Rheumatoid Arthritis can be well controlled with early diagnosis, proper medication, and regular follow-up.
Think of it like a fire – if treated early, we can put it out before it causes damage.

🩺 Stay in close contact with your rheumatologist and never stop medications without advice.

Contact us

© 2025 rheumatology

Design by PrideCC