query: What is rheumatoid arthritis?

title: Rheumatoid arthritis

text: Rheumatoid arthritis Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and hands are involved, with the same joints typically involved on both sides of the body. The disease may also affect other parts of the body. This may result in a low red blood cell count, inflammation around the lungs, and inflammation around the heart. Fever and low energy may also be present. Often, symptoms come on gradually over weeks to months. While the cause of

title: Rheumatoid arthritis

text: rheumatoid arthritis is not clear, it is believed to involve a combination of genetic and environmental factors. The underlying mechanism involves the body's immune system attacking the joints. This results in inflammation and thickening of the joint capsule. It also affects the underlying bone and cartilage. The diagnosis is made mostly on the basis of a person's signs and symptoms. X-rays and laboratory testing may support a diagnosis or exclude other diseases with similar symptoms. Other diseases that may present similarly include systemic lupus erythematosus, psoriatic arthritis, and fibromyalgia among others. The goals of treatment are to reduce pain, decrease

title: Rheumatoid arthritis

text: in assessing the degree of synovial inflammation as they can show vascular signals of active synovitis. This is important, since in the early stages of RA, the synovium is primarily affected, and synovitis seems to be the best predictive marker of future joint damage. When RA is clinically suspected, a physician may test for rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPAs measured as anti-CCP antibodies). It is positive in 75-85%, but a negative RF or CCP antibody does not rule out RA, rather, the arthritis is called "seronegative", which is in about 15-25% of people with RA. During the

title: Rheumatoid arthritis

text: apple diet, nutmeg, some light exercise every now and then, nettles, bee venom, copper bracelets, rhubarb diet, extractions of teeth, fasting, honey, vitamins, insulin, magnets, and electroconvulsive therapy (ECT). Rheumatoid arthritis is derived from the Greek word "ῥεύμα-rheuma (nom.), ῥεύματος-rheumatos (gen.)" ("flow, current"). The suffix -"oid" ("resembling") gives the translation as "joint inflammation that resembles rheumatic fever". Rhuma which means watery discharge might refer to the fact that the joints are swollen or that the disease may be made worse by wet weather. Meta-analysis found an association between periodontal disease and RA, but the mechanism of this association remains unclear.

title: Rheumatoid arthritis

text: erosion of the joint surface causing deformity and loss of function. RA typically manifests with signs of inflammation, with the affected joints being swollen, warm, painful and stiff, particularly early in the morning on waking or following prolonged inactivity. Increased stiffness early in the morning is often a prominent feature of the disease and typically lasts for more than an hour. Gentle movements may relieve symptoms in early stages of the disease. These signs help distinguish rheumatoid from non-inflammatory problems of the joints, such as osteoarthritis. In arthritis of non-inflammatory causes, signs of inflammation and early morning stiffness are less

title: Knee arthritis

text: Knee arthritis Arthritis is inflammation of the joints (the area of the body where two bones come together). Types of arthritis include those related to wear and tear of cartilage, such as osteoarthritis, to those associated with inflammation resulting from an overactive immune system, such as rheumatoid arthritis. The one part of the body that is most affected by arthritis is the knee. The knee can be affected by both rheumatoid arthritis, or osteoarthritis. It is not always certain why arthritis of the knee develops. Most physicians believe that it is a combination of factors that can include muscle weakness,

title: Psoriatic arthritis

text: of psoriatic arthritis include the following: Other symptoms that are more typical of psoriatic arthritis than other forms of arthritis include enthesitis (inflammation in the Achilles tendon (at the back of the heel) or the plantar fascia (bottom of the feet)), and dactylitis (sausage-like swelling of the fingers or toes). Several conditions can mimic the clinical presentation of psoriatic arthritis including rheumatoid arthritis, osteoarthritis, reactive arthritis, gouty arthritis, systemic lupus erythematosus, and inflammatory bowel disease-associated arthritis. In contrast to psoriatic arthritis, rheumatoid arthritis tends to affect the proximal joints (e.g., the metacarpophalangeal joints), involves a greater number of joints than

title: Rheumatoid arthritis

text: mechanisms – which normally maintain tolerance – are overtaken by positive feedback mechanisms for certain antigens, such as IgG Fc bound by rheumatoid factor and citrullinated fibrinogen bound by antibodies to citrullinated peptides (ACPA - Anti–citrullinated protein antibody). A debate on the relative roles of B-cell produced immune complexes and T cell products in inflammation in RA has continued for 30 years, but neither cell is necessary at the site of inflammation, only autoantibodies to IgGFc, known as rheumatoid factors and ACPA, with ACPA having a 80% specificity for diagnosing RA. As with other autoimmune diseases, people with RA have

title: Childhood arthritis

text: Childhood arthritis Juvenile arthritis (JA), also known as childhood arthritis, is any form of chronic arthritis or chronic arthritis-related conditions which affects individuals under the age of 16. It is an autoimmune disease. Three types of juvenile arthritis exist—juvenile rheumatoid arthritis (JRA), juvenile chronic arthritis (JCA), and juvenile idiopathic arthritis (JIA), of which JRA is the most common. JRA again can be divided into three main forms: The classification is based upon symptoms, number of joints involved and the presence of certain antibodies in the blood. In most cases, juvenile arthritis is caused by the body attacking its own healthy

title: Arthritis

text: (Th) cells, specifically Th17 cells. Th17 cells are present in higher quantities at the site of bone destruction in joints and produce inflammatory cytokines associated with inflammation, such as interleukin-17 (IL-17). Bone erosion is a central feature of rheumatoid arthritis. Bone continuously undergoes remodeling by actions of bone resorbing osteoclasts and bone forming osteoblasts. One of the main triggers of bone erosion in the joints in rheumatoid arthritis is inflammation of the synovium, caused in part by the production of pro-inflammatory cytokines and receptor activator of nuclear factor kappa B ligand (RANKL), a cell surface protein present in Th17 cells

title: Psoriatic arthritis

text: psoriatic arthritis, and affect them symmetrically. Involvement of the spinal joints is more suggestive of psoriatic arthritis than rheumatoid arthritis. Osteoarthritis shares certain clinical features with psoriatic arthritis such as its tendency to affect multiple distal joints in an asymmetric pattern. Unlike psoriatic arthritis, osteoarthritis does not typically involve inflammation of the sacroiliac joint. Psoriatic arthritis sometimes affects only one joint and is sometimes confused for gout or pseudogout when this happens. There are five main types of psoriatic arthritis: The underlying process in psoriatic arthritis is inflammation; therefore, treatments are directed at reducing and controlling inflammation. Milder cases of

title: Knee arthritis

text: performed if one side of the knee is damaged. Arthroplasty is a replacement surgery where an artificial joint is used. Low level laser therapy can be considered for relief of pain and stiffness associated with osteoarthritis. Knee arthritis Arthritis is inflammation of the joints (the area of the body where two bones come together). Types of arthritis include those related to wear and tear of cartilage, such as osteoarthritis, to those associated with inflammation resulting from an overactive immune system, such as rheumatoid arthritis. The one part of the body that is most affected by arthritis is the knee. The

title: Rheumatoid arthritis

text: first year of illness, rheumatoid factor is more likely to be negative with some individuals becoming seropositive over time. RF is a non-specific antibody and seen in about 10% of healthy people, in many other chronic infections like hepatitis C, and chronic autoimmune diseases such as Sjögren's syndrome and systemic lupus erythematosus. Therefore, the test is not specific for RA. Hence, new serological tests check for anti-citrullinated protein antibodies ACPAs . These tests are again positive in 61-75% of all RA cases, but with a specificity of around 95%. As with RF, ACPAs are many times present before symptoms have

title: Psoriatic arthritis

text: "pencil-in-cup" appearance. Because prolonged inflammation can lead to joint damage, early diagnosis and treatment to slow or prevent joint damage is recommended. The exact causes are not yet known, but a number of genetic associations have been identified in a genome-wide association study of psoriasis and psoriatic arthritis including HLA-B27. There is no definitive test to diagnose psoriatic arthritis. Symptoms of psoriatic arthritis may closely resemble other diseases, including rheumatoid arthritis. A rheumatologist (a doctor specializing in autoimmune diseases) may use physical examinations, health history, blood tests and x-rays to accurately diagnose psoriatic arthritis. Factors that contribute to a diagnosis

title: Rheumatoid arthritis

text: abnormally glycosylated antibodies, which are believed to promote joint inflammation. Once the generalized abnormal immune response has become established – which may take several years before any symptoms occur – plasma cells derived from B lymphocytes produce rheumatoid factors and ACPA of the IgG and IgM classes in large quantities. These activate macrophages through Fc receptor and complement binding, which is part of the intense inflammation in RA. Binding of an autoreactive antibody to the Fc receptors is mediated through the antibody's N-glycans, which are altered to promote inflammation in people with RA. This contributes to local inflammation in a

title: Septic arthritis

text: rates generally range from 10-20%. These rates increase depending on the offending organism, older age, and comorbidities such as rheumatoid arthritis. Septic arthritis Septic arthritis, also known as joint infection or infectious arthritis, is the invasion of a joint by an infectious agent resulting in joint inflammation. Symptoms typically include redness, heat, and pain in a single joint associated with a decreased ability to move the joint. Onset is usually rapid. Other symptoms may include fever, weakness, and headache. Occasionally, more than one joint may be involved. Causes include bacteria, viruses, fungi, and parasites. Risk factors include an artificial joint,

title: Juvenile idiopathic arthritis

text: "idiopathic" in alternate entries. Juvenile idiopathic arthritis Juvenile idiopathic arthritis (JIA), also known as juvenile rheumatoid arthritis, is the most common form of arthritis in children and adolescents. ("Juvenile" in this context refers to an onset before age 16, "idiopathic" refers to a condition with no defined cause, and "arthritis" is the inflammation of the synovium of a joint.) JIA is an autoimmune, noninfective, inflammatory joint disease of more than 6 weeks duration in children less than 16 years of age. The disease commonly occurs in children from the ages of 1 to 6, but it may develop as late

title: Juvenile idiopathic arthritis

text: Juvenile idiopathic arthritis Juvenile idiopathic arthritis (JIA), also known as juvenile rheumatoid arthritis, is the most common form of arthritis in children and adolescents. ("Juvenile" in this context refers to an onset before age 16, "idiopathic" refers to a condition with no defined cause, and "arthritis" is the inflammation of the synovium of a joint.) JIA is an autoimmune, noninfective, inflammatory joint disease of more than 6 weeks duration in children less than 16 years of age. The disease commonly occurs in children from the ages of 1 to 6, but it may develop as late as 15 years of

title: Arthritis Australia

text: and run community seminars. Arthritis is an umbrella term for more than 100 medical conditions that affect the musculoskeletal system, specifically joints where two or more bones meet. The three most significant – osteoarthritis, rheumatoid arthritis and gout – account for more than 95 per cent of cases in Australia. The most common forms of arthritis are: Arthritis-related problems include pain, stiffness, inflammation and damage to joint cartilage (the tissue that covers the ends of bones, enabling them to move against each another) and surrounding structures. This can result in joint weakness, instability and deformities that can interfere with the

title: Rheumatoid arthritis

text: and 50 years of age, and for men somewhat later. RA is a chronic disease, and although rarely, a spontaneous remission may occur, the natural course is almost invariably one of the persistent symptoms, waxing and waning in intensity, and a progressive deterioration of joint structures leading to deformations and disability. The first known traces of arthritis date back at least as far as 4500 BC. A text dated 123 AD first describes symptoms very similar to RA. It was noted in skeletal remains of Native Americans found in Tennessee. In Europe, the disease is vanishingly rare before the 17th

title: Arthritis

text: loss of hand function. There is no known cure for either rheumatoid or osteoarthritis. Treatment options vary depending on the type of arthritis and include physical therapy, lifestyle changes (including exercise and weight control), orthopedic bracing, and medications. Joint replacement surgery may be required in eroding forms of arthritis. Medications can help reduce inflammation in the joint which decreases pain. Moreover, by decreasing inflammation, the joint damage may be slowed. In general, studies have shown that physical exercise of the affected joint can noticeably improve long-term pain relief. Furthermore, exercise of the arthritic joint is encouraged to maintain the health

title: Rheumatoid lung disease

text: rheumatoid lung disease is unknown. However, associated factors could be due largely to smoking. Sometimes, the medicines used to treat rheumatoid arthritis, especially methotrexate, may result in lung disease. Prevention's: Many people with this condition have no symptoms. Treatment is aimed at the health problems causing the lung problem and the complications caused by the disorder. Fast-acting drugs for RA include aspirin and corticosteroids, which alleviate pain and reduce inflammation. Slow-acting drugs termed disease modifying antirheumatic drugs (DMARDs), include gold, methotrexate and hydroxychloroquine (Plaquenil), which promote disease remission and prevent progressive joint destruction. In patients with less severe RA, pain

title: Systemic-onset juvenile idiopathic arthritis

text: Systemic-onset juvenile idiopathic arthritis Systemic-onset juvenile idiopathic arthritis (also known as systemic juvenile idiopathic arthritis (sJIA) or the juvenile onset form of Still's disease) is a type of juvenile idiopathic arthritis (JIA) with extra-articular manifestations like fever and rash apart from arthritis. It was originally called systemic-onset juvenile rheumatoid arthritis or Still's disease. Predominantly extra-articular manifestations like high fevers, rheumatic rash, enlargement of the liver and spleen, enlargement of the lymph nodes, and anemia. Others manifestations include inflammation of the pleura, inflammation of the pericardium, inflammation of the heart's muscular tissue, and inflammation of the peritoneum are also seen. It

title: Rheumatoid arthritis

text: RA primarily affects joints, but it also affects other organs in more than 15–25% of cases. Associated problems include cardiovascular disease, osteoporosis, interstitial lung disease, infection, cancer, feeling tired, depression, mental difficulties, and trouble working. Arthritis of joints involves inflammation of the synovial membrane. Joints become swollen, tender and warm, and stiffness limits their movement. With time, multiple joints are affected (polyarthritis). Most commonly involved are the small joints of the hands, feet and cervical spine, but larger joints like the shoulder and knee can also be involved. Synovitis can lead to tethering of tissue with loss of movement and

title: Juvenile idiopathic arthritis

text: migration inhibitory factor has been associated with this condition. It is sometimes called "adolescent-onset Still's disease", to distinguish it from adult-onset Still's disease. However, some evidence shows the two conditions are closely related. Rheumatoid factor and ANA are generally negative in systemic JIA. Some doctors include two other, less common forms: enthesitis-related arthritis and psoriatic JIA. Enthesitis is an inflammation of the insertion points of the tendons. This form occurs most often in boys older than 8, large joints of lower extremities are commonly affected; characteristically, it causes back pain, and is linked to ankylosing spondylitis and inflammatory bowel disease.

title: Immunologic checkpoint

text: stage IV. In autoimmune rheumatic diseases, impaired tolerance leads to the development of diseases such as rheumatoid arthritis, systemic sclerosis, systemic lupus erythematosus, Sjogren’s syndrome, etc. Therefore, in autoimmune diseases the converse strategy of engaging immunological checkpoints may be beneficial: stimulate inhibitory molecules of the immune system, thus inhibiting the immune system (therefore, increase self-tolerance). What is known to work is Abatacept, an CD152-Ig used in treating rheumatoid arthritis and juvenile idiopathic arthritis. Not studied enough yet are the therapeutic opportunities using Programmed death-1 pathway. Immunologic checkpoint An immune checkpoint regulator is a modulator of the immune system, that allows

title: T helper 17 cell

text: case of rheumatoid arthritis. T17 cells have also been shown to be necessary for maintenance of mucosal immunity. In HIV, the loss of T17 cell populations can contribute to chronic infection. T17 cells, particularly auto-specific T17 cells, are associated with autoimmune disease such as multiple sclerosis, rheumatoid arthritis, and psoriasis. T17 overactivation against autoantigen will cause type 3 immune complex and complement-mediated hypersensitivity. Rheumatoid arthritis or Arthus reaction belong to this category. Bone erosion caused by mature osteoclast cells is common in patients with rheumatoid arthritis. Activated T helper cells such as Th1, Th2, and Th17 are found in the

title: Osteopontin

text: useful in the treatment of autoimmune diseases, cancer metastasis, bone (and tooth) mineralization diseases, osteoporosis, and some forms of stress. OPN has been implicated in pathogenesis of rheumatoid arthritis. For instance, researchers found that OPN-R, the thrombin-cleaved form of OPN, was elevated in the rheumatoid arthritis joint. However, the role of OPN in rheumatoid arthritis is still unclear. One group found that OPN knock-out mice were protected against arthritis. while others were not able to reproduce this observation. OPN has been found to play a role in other autoimmune diseases including autoimmune hepatitis, allergic airway disease, and multiple sclerosis. It

title: QT interval

text: as a predictor of mortality for diseased subsets of the population. Rheumatoid arthritis is the most common inflammatory arthritis. Studies have linked rheumatoid arthritis with increased death from cardiovascular disease. In a 2014 study, Panoulas et al. found a 50 ms increase in QTc interval increased the odds of all-cause mortality by 2.17 in patients with rheumatoid arthritis. Patients with the highest QTc interval (> 424 ms) had higher mortality than those with a lower QTc interval. The association was lost when calculations were adjusted for C-reactive protein levels. The researchers proposed that inflammation prolonged the QTc interval and created

title: Arthritis

text: arthritis. Overall the disease becomes more common with age. Arthritis is a common reason that people miss work and can result in a decreased quality of life. The term is derived from "arthr-" (meaning joint) and "-itis" (meaning inflammation). There are several diseases where joint pain is primary, and is considered the main feature. Generally when a person has "arthritis" it means that they have one of these diseases, which include: Joint pain can also be a symptom of other diseases. In this case, the arthritis is considered to be secondary to the main disease; these include: An "undifferentiated arthritis"

title: Rheumatoid arthritis

text: Two bacterial species associated with periodontitis are implicated as mediators of protein citrullination in the gums of people with RA. Vitamin D deficiency is more common in people with rheumatoid arthritis than in the general population. However, whether vitamin D deficiency is a cause or a consequence of the disease remains unclear. One meta-analysis found that vitamin D levels are low in people with rheumatoid arthritis and that vitamin D status correlates inversely with prevalence of rheumatoid arthritis, suggesting that vitamin D deficiency is associated with susceptibility to rheumatoid arthritis. Rheumatoid arthritis Rheumatoid arthritis (RA) is a long-term autoimmune disorder

title: Rheumatoid arthritis

text: sign of Still's disease, a seronegative, usually juvenile, variant of rheumatoid arthritis. In 2010 the "2010 ACR / EULAR Rheumatoid Arthritis Classification Criteria" were introduced. The new criterion is not a diagnostic criterion but a classification criterion to identify disease with a high likelihood of developing a chronic form. However a score of 6 or greater unequivocally classifies a person with a diagnosis of rheumatoid arthritis. These new classification criteria overruled the "old" ACR criteria of 1987 and are adapted for early RA diagnosis. The "new" classification criteria, jointly published by the American College of Rheumatology (ACR) and the European

title: Rheumatoid arthritis

text: herb thunder god vine (Tripterygium wilfordii) can have serious side effects." There is conflicting evidence on the role of erythropoiesis-stimulating agents for treatment of anemia in persons with rheumatoid arthritis. More than 75% of women with rheumatoid arthritis have symptoms improve during pregnancy but might have symptoms worsen after delivery. Methotrexate and leflunomide are teratogenic (harmful to foetus) and not used in pregnancy. It is recommended women of childbearing age should use contraceptives to avoid pregnancy and to discontinue its use if pregnancy is planned. Low dose of prednisolone, hydroxychloroquine and sulfasalazine are considered safe in pregnant persons with rheumatoid

title: Rheumatoid arthritis

text: due to involvement of small- and medium-sized vessels. Rheumatoid vasculitis can thus commonly present with skin ulceration and vasculitic nerve infarction known as mononeuritis multiplex. Other, rather rare, skin associated symptoms include pyoderma gangrenosum, Sweet's syndrome, drug reactions, erythema nodosum, lobe panniculitis, atrophy of finger skin, palmar erythema, and skin fragility (often worsened by corticosteroid use). Diffuse alopecia areata (Diffuse AA) occurs more commonly in people with rheumatoid arthritis. RA is also seen more often in those with relatives who have AA. Lung fibrosis is a recognized complication of rheumatoid arthritis. It is also a rare but well-recognized consequence of

title: Rheumatoid arthritis

text: their current use in the management of RA.". Studies showing beneficial effects in RA on a wide variety of CAM modalities are often affected by publication bias and are generally not high quality evidence such as randomized controlled trials (RCTs). A 2005 Cochrane review states that low level laser therapy can be tried to improve pain and morning stiffness due to rheumatoid arthritis as there are few side-effects. There is some evidence that Tai Chi improves the range of motion of a joint in persons with rheumatoid arthritis. The evidence for acupuncture is inconclusive with it appearing to be equivalent

title: Rheumatoid arthritis

text: may be used to help manage pain. RA should generally be treated with at least one specific anti-rheumatic medication. The use of benzodiazepines (such as diazepam) to treat the pain is not recommended as it does not appear to help and is associated with risks. Regular exercise is recommended as both safe and useful to maintain muscles strength and overall physical function. It is uncertain if specific dietary measures have an effect. Physical activity is beneficial for persons with rheumatoid arthritis complaining of fatigue. Occupational therapy has a positive role to play in improving functional ability of persons with rheumatoid

title: The Rheumatoid Arthritis Quality of Life Questionnaire

text: in order to confirm the responsiveness and validity of the language adaptations. The RAQoL has been used in clinical studies in order to confirm the efficacy of proposed treatments of rheumatoid arthritis. It has been utilized in order to confirm the efficacy of tocilizumab and infliximab. The Rheumatoid Arthritis Quality of Life Questionnaire The Rheumatoid Arthritis Quality of Life Questionnaire (RAQoL) is a disease specific patient-reported outcome measure which determines the effect rheumatoid arthritis has on a patient’s quality of life. The RAQoL has 30 items with a yes and no response format and takes about six minutes to complete.

title: Rheumatoid arthritis

text: of lymphocytes and plasma cells, corresponding to the subintimal zone in synovitis. The typical rheumatoid nodule may be a few millimetres to a few centimetres in diameter and is usually found over bony prominences, such as the elbow, the heel, the knuckles, or other areas that sustain repeated mechanical stress. Nodules are associated with a positive RF (rheumatoid factor) titer, ACPA, and severe erosive arthritis. Rarely, these can occur in internal organs or at diverse sites on the body. Several forms of vasculitis occur in RA, but are mostly seen with long-standing and untreated disease. The most common presentation is

title: Rheumatoid arthritis

text: damage that treatment is meant to avoid. In clinical practice, the following criteria apply: Several other medical conditions can resemble RA, and need to be distinguished from it at the time of diagnosis: Rarer causes which usually behave differently but may cause joint pains: Sometimes arthritis is in an undifferentiated stage (i.e. none of the above criteria is positive), even if synovitis is witnessed and assessed with ultrasound imaging. Many tools can be used to monitor remission in rheumatoid arthritis. formula_1 From this, the disease activity of the affected person can be classified as follows: It is not always a

text: The Rheumatoid Arthritis Quality of Life Questionnaire The Rheumatoid Arthritis Quality of Life Questionnaire (RAQoL) is a disease specific patient-reported outcome measure which determines the effect rheumatoid arthritis has on a patient’s quality of life. The RAQoL has 30 items with a yes and no response format and takes about six minutes to complete. Scores on the RAQoL are a sum of all the individual item scores with a range from 0-30, with a lower score indicating better quality of life. The RAQoL is a self-assessment questionnaire, meaning patients fill out the survey themselves in order to avoid experimental error.

title: Rheumatoid arthritis

text: not supported by evidence. RA affects about 24.5 million people as of 2015. This is between 0.5 and 1% of adults in the developed world with 5 and 50 per 100,000 people newly developing the condition each year. Onset is most frequent during middle age and women are affected 2.5 times as frequently as men. In 2013, it resulted in 38,000 deaths up from 28,000 deaths in 1990. The first recognized description of RA was made in 1800 by Dr. Augustin Jacob Landré-Beauvais (1772–1840) of Paris. The term "rheumatoid arthritis" is based on the Greek for watery and inflamed joints.

title: Rheumatoid arthritis

text: cells, i.e. activated T- and B cells, monocytes and macrophages from activated fibroblasts, in the joint space. By signalling through RANKL and RANK, they eventually trigger osteoclast production, which degrades bone tissue. Tumor necrosis factors (TNF alpha) plays a major role and several theories exist on how TNF release happens in RA. Tumor necrosis factor‐alpha (TNF‐α) is a proinflammatory cytokine that plays a pivotal role in regulating the inflammatory response in rheumatoid arthritis (RA).If TNF release is stimulated by B cell products in the form of RF or ACPA -containing immune complexes, through activation of immunoglobulin Fc receptors, then RA

title: Rheumatoid arthritis

text: deformity", flexion of proximal interphalangeal joint and extension of distal interphalangeal joint of the hand), swan neck deformity (hyperextension at proximal interphalangeal joint and flexion at distal interphalangeal joint) and "Z-thumb." "Z-thumb" or "Z-deformity" consists of hyperextension of the interphalangeal joint, fixed flexion and subluxation of the metacarpophalangeal joint and gives a "Z" appearance to the thumb. The hammer toe deformity may be seen. In the worst case, joints are known as arthritis mutilans due to the mutilating nature of the deformities. The rheumatoid nodule, which is sometimes in the skin, is the most common non-joint feature and occurs in

title: Rheumatoid arthritis

text: century. The first recognized description of RA in modern medicine was in 1800 by the French physician Dr Augustin Jacob Landré-Beauvais (1772–1840) who was based in the famed Salpêtrière Hospital in Paris. The name "rheumatoid arthritis" itself was coined in 1859 by British rheumatologist Dr Alfred Baring Garrod. An anomaly has been noticed from the investigation of Pre-Columbian bones. The bones from the Tennessee site show no signs of tuberculosis even though it was prevalent at the time throughout the Americas. The art of Peter Paul Rubens may possibly depict the effects of RA. In his later paintings, his rendered

title: Rheumatoid arthritis

text: are not effective after a trial of three months. They are associated with a higher rate of serious infections as compared to other DMARDs. Biological DMARD agents used to treat rheumatoid arthritis include: tumor necrosis factor alpha (TNFα) blockers such as infliximab; interleukin 1 blockers such as anakinra, monoclonal antibodies against B cells such as rituximab, and tocilizumab T cell co-stimulation blocker such as abatacept. They are often used in combination with either methotrexate or leflunomide. Abatacept should not be used at the same time as other biologics. In those who are well controlled on TNF blockers decreasing the dose

title: Rheumatoid factor

text: between rheumatoid factor and more persistently active synovitis, more joint damage, greater eventual disability and arthritis. Other than in rheumatoid arthritis, rheumatoid factor may also be elevated in: The test was first described by Norwegian Dr Erik Waaler in 1940 and redescribed by Dr Harry M. Rose and colleagues in 1948. Redescription is said to be due to the uncertainties due to World War II. It is still referred to as the Waaler-Rose test. Rheumatoid factor Rheumatoid factor (RF) is the autoantibody that was first found in rheumatoid arthritis. It is defined as an antibody against the Fc portion of

title: Rheumatoid pleuritis

text: of treatment for rheumatoid arthritis, and have been shown to improve rheumatoid pleuritis. Rheumatoid pleuritis Rheumatoid pleuritis, a form of pleural effusion, is an uncommon complication of rheumatoid arthritis, occurring in 2-3% of patients (Walker and Wright, 1967; Naylor, 1990) Pleural effusion usually occurs in patients previously diagnosed with rheumatoid arthritis, but it can also occur concurrently with or before the development of the joint manifestations of the disease (Graham, 1990; Chou and Chang, 2002). Patients may present with the signs of pleural effusion: dullness on percussion, diminished or absent breath sounds and vocal fremitus, and egophony at the level

title: Rheumatoid nodule

text: priority for people with rheumatoid arthritis. However, surgical removal is often successful, even if there is a tendency for nodules to regrow. Of the drug therapies commonly used in rheumatoid arthritis, methotrexate has the disadvantage of tending to make nodules worse. TNF inhibitors do not have a very reliable effect on nodules. B cell depletion with rituximab often leads to disappearance of nodules but this is not guaranteed. Rheumatoid nodule A rheumatoid nodule is a local swelling or tissue lump, usually rather firm to touch, like an unripe fruit, which occurs almost exclusively in association with rheumatoid arthritis. Very rarely

title: Rheumatoid lung disease

text: Rheumatoid lung disease Rheumatoid Lung Disease, also called Rheumatoid Lung is a disease of the lung associated with RA, rheumatoid arthritis. Rheumatoid lung disease is characterized by pleural effusion, pulmonary fibrosis, lung nodules and pulmonary hypertension. Common symptoms associated with the disease include shortness of breath, cough, chest pain and fever. It is estimated that about one quarter of people with rheumatoid arthritis develop this disease, which are more likely to develop among elderly men with a history of smoking. Rheumatoid lung is separate from but often associated with Interstitial lung disease(ILD). The prevalence of RA is around 0.3–1.2% (0.92%

title: Arthritis mutilans

text: edema, bone erosions, and new bone growth. Most often psoriatic arthritis is seronegative for rheumatoid factor (occurring in only about 13% of cases), and has genetic risk factor overlap with ankylosing spondylitis with HLA-B27, IL-23R77, and IL-1, however, as of 2016, immunopathogenesis is unclear. Enthesitis can assist in differentiating arthritis mutilans' parent condition psoriatic arthritis from rheumatoid arthritis and osteoarthritis, with evidence in plain radiographs (x-rays) and MRI as periostitis, new bone formation, and bone erosions. Dactylitis, spondylitis and sacroiliitis are common with the parent condition psoriatic arthritis, but are not in rheumatoid arthritis. MRI bone edema scores are high

title: Rheumatoid factor

text: immunoglobulins, i.e. IgA, IgG, IgM, IgE, IgD. RF is often evaluated in patients suspected of having any form of arthritis even though positive results can be due to other causes, and negative results do not rule out disease. But, in combination with signs and symptoms, it can play a role in both diagnosis and disease prognosis. It is part of the usual disease criteria of rheumatoid arthritis. The presence of rheumatoid factor in serum can also indicate the occurrence of suspected autoimmune activity unrelated to rheumatoid arthritis, such as that associated with tissue or organ rejection. In such instances, RF

title: Rheumatoid nodule

text: Rheumatoid nodule A rheumatoid nodule is a local swelling or tissue lump, usually rather firm to touch, like an unripe fruit, which occurs almost exclusively in association with rheumatoid arthritis. Very rarely rheumatoid nodules occur as rheumatoid nodulosis in the absence of arthritis. They are usually subcutaneous especially over bony prominences such as the olecranon (tip of the elbow) or the interphalangeal joints (finger knuckles). Less commonly they occur in the lining of the lung and other internal organs. The occurrence of nodules in the lung of miners exposed to silica dust was known as Caplan's syndrome. Nodules vary in

title: Juvenile idiopathic arthritis

text: age. It is a subset of arthritis seen in childhood, which may be transient and self-limited or chronic. It differs significantly from arthritis commonly seen in adults (osteoarthritis, rheumatoid arthritis), and other types of arthritis that can present in childhood which are chronic conditions (e.g. psoriatic arthritis and ankylosing spondylitis). Aetiopathology is similar to rheumatoid arthritis, but with less marked cartilage erosion, and joint instability and absent rheumatoid factor. JIA affects about one in 1,000 children in any given year, with about one in 10,000 having a more severe form. Symptoms of JIA are often nonspecific initially, and include lethargy,

title: Arthritis

text: Arthritis Arthritis is a term often used to mean any disorder that affects joints. Symptoms generally include joint pain and stiffness. Other symptoms may include redness, warmth, swelling, and decreased range of motion of the affected joints. In some types other organs are also affected. Onset can be gradual or sudden. There are over 100 types of arthritis. The most common forms are osteoarthritis (degenerative joint disease) and rheumatoid arthritis. Osteoarthritis usually occurs with age and affects the fingers, knees, and hips. Rheumatoid arthritis is an autoimmune disorder that often affects the hands and feet. Other types include gout, lupus,

title: Rheumatoid pleuritis

text: Rheumatoid pleuritis Rheumatoid pleuritis, a form of pleural effusion, is an uncommon complication of rheumatoid arthritis, occurring in 2-3% of patients (Walker and Wright, 1967; Naylor, 1990) Pleural effusion usually occurs in patients previously diagnosed with rheumatoid arthritis, but it can also occur concurrently with or before the development of the joint manifestations of the disease (Graham, 1990; Chou and Chang, 2002). Patients may present with the signs of pleural effusion: dullness on percussion, diminished or absent breath sounds and vocal fremitus, and egophony at the level of the pleural liquid. Light microscopy reveals replacement of normal cells lining the

title: Rheumatoid factor

text: may serve as one of several serological markers for autoimmunity. The sensitivity of RF for established rheumatoid arthritis is only 60-70% with a specificity of 78%. High levels of rheumatoid factor (in general, above 20 IU/mL, 1:40, or over the 95th percentile; there is some variation among labs) occur in rheumatoid arthritis (present in 80%) and Sjögren's syndrome (present in 70%). The higher the level of RF the greater the probability of destructive articular disease. It is also found in Epstein–Barr virus or Parvovirus infection and in 5 to 10% of healthy persons, especially the elderly. There is an association

title: Arthritis mutilans

text: luxation, phalangeal and metacarpal bone absorption, and skeletal architecture loss in the fingers occurs. Arthritis mutilans occurs mainly in people who have pre-existing psoriatic arthritis, but can occur, if less often, in advanced rheumatoid arthritis; it can also occur independently. Psoriasis and psoriatic arthritis are interrelated heritable diseases, occurring with greater heritable frequency than rheumatoid arthritis, primary Sjogren's syndrome and thyroid disease. Psoriasis affects 2–3% of the Caucasian population, and psoriatic arthritis affects up to 30% of those. Arthritis mutilans presents in about 5–16% of psoriatic arthritis cases, involves osteolysis of the DIP and PIP joints, and can include bone

title: Juvenile idiopathic arthritis

text: as juvenile chronic arthritis (JCA), a term that is not precise as JIA does not encompass all forms of chronic childhood arthritis. A majority of cases are rheumatoid factor negative, which leads some to consider the "chronic" or "idiopathic" labels more appropriate. However, if a cause was determined, then "idiopathic" may no longer be appropriate (making JIA a diagnosis of exclusion), and if the course was self-limited, then "chronic" may no longer be appropriate. Adding to the confusion, the term rheumatoid itself lacks a consistent, unambiguous definition. MeSH uses "juvenile rheumatoid arthritis" as the primary entry, and uses "chronic" and

title: Rheumatoid factor

text: Rheumatoid factor Rheumatoid factor (RF) is the autoantibody that was first found in rheumatoid arthritis. It is defined as an antibody against the Fc portion of IgG and different RFs can recognize different parts of the IgG-Fc. RF and IgG join to form immune complexes that contribute to the disease process. Rheumatoid factor can also be a cryoglobulin (antibody that precipitates on cooling of a blood sample); it can be either type 2 (monoclonal IgM to polyclonal IgG) or type 3 (polyclonal IgM to polyclonal IgG) cryoglobulin. Although predominantly encountered as IgM, rheumatoid factor can be of any isotype of

text: The RAQoL was developed by Galen Research, the University of Leeds and the Academic Hospital Maastricht, and was first published in 1997. It was the first patient completed quality of life questionnaire that focused on rheumatoid arthritis and is distinct from other questionnaires as it includes physical contact as a dimension of quality of life. Other dimensions include activities of daily living, social interaction/function, emotions, mood and recreation and pastimes. Since its development, the RAQOL has been translated into 33 languages other than Dutch and UK English. Validation studies have been performed in countries such as Sweden, Argentina and Australia

title: Arthritis

text: is an arthritis that does not fit into well-known clinical disease categories, possibly being an early stage of a definite rheumatic disease. Pain, which can vary in severity, is a common symptom in virtually all types of arthritis. Other symptoms include swelling, joint stiffness and aching around the joint(s). Arthritic disorders like lupus and rheumatoid arthritis can affect other organs in the body, leading to a variety of symptoms. Symptoms may include: It is common in advanced arthritis for significant secondary changes to occur. For example, arthritic symptoms might make it difficult for a person to move around and/or exercise,

title: Inflammatory arthritis

text: Inflammatory arthritis Inflammatory arthritis is a group of diseases which includes: rheumatoid arthritis, psoriatic arthropathy, inflammatory bowel disease, adult-onset Still's disease, scleroderma, juvenile idiopathic arthritis and systemic lupus erythematosus (SLE). Symptoms of inflammatory arthritis include stiffness, pain, and swelling of the joints, restricted motions, and reduced physical strength. Other symptoms may include systemic complaints including fatigue. Treatments for inflammatory arthritis vary by subtype, though they may include drugs like DMARDs (disease-modifying anti-rheumatic drugs) and tumor necrosis factor inhibitors. Inflammatory arthritis can be disabling to the point where people with the diseases can lose their jobs, which can cause psychological distress.

title: Inflammatory arthritis

text: Because it is typically progressive, those who lose their jobs are unlikely to re-enter the workforce after leaving due to their diagnosis. Programs now aim to retain those with inflammatory arthritis by preventing work-related injuries and by making necessary accommodations in the workplace. A 2014 Cochrane review found low-quality evidence that work focused interventions, including counseling, education, advocacy, and occupational medicine consultations, were effective in retaining workers with inflammatory arthritis. The worldwide prevalence of inflammatory arthritis is approximately 3%. Rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and undifferentiated spondyloarthritis are the most common subtypes of inflammatory arthritis. The diseases occur most

title: Shoulder arthritis

text: skate on ice. In arthritis, this cartilage is progressively lost, exposing the bone beneath. Shoulder arthritis is characterized by pain, stiffness, and loss of function and often by a grinding on shoulder motion. One of the three forms of shoulder arthritis is osteoarthritis. Osteoarthritis is the gradual wearing down of the joint cartilage that occurs predominantly in elderly people, and sometimes as the result of overuse in athletes. Post-traumatic arthritis happens after a significant trauma is sustained by the joint, ruining the cartilage. This could be the result of a car accident or after repeated trauma. Rheumatoid arthritis is a

title: Inflammatory arthritis

text: commonly in the 30-40 age group. Inflammatory arthritis Inflammatory arthritis is a group of diseases which includes: rheumatoid arthritis, psoriatic arthropathy, inflammatory bowel disease, adult-onset Still's disease, scleroderma, juvenile idiopathic arthritis and systemic lupus erythematosus (SLE). Symptoms of inflammatory arthritis include stiffness, pain, and swelling of the joints, restricted motions, and reduced physical strength. Other symptoms may include systemic complaints including fatigue. Treatments for inflammatory arthritis vary by subtype, though they may include drugs like DMARDs (disease-modifying anti-rheumatic drugs) and tumor necrosis factor inhibitors. Inflammatory arthritis can be disabling to the point where people with the diseases can lose their

title: Arthritis Foundation

text: for the more than 100 types of the disease, including conditions like osteoarthritis, rheumatoid arthritis, juvenile arthritis, gout, fibromyalgia and psoriatic arthritis. Community events and programs run by the Arthritis Foundation help educate the public about the realities of arthritis, raise funds and awareness, and encourage people with arthritis to manage their joint pain and improve overall health. Nationwide activities include Walk to Cure Arthritis and Jingle Bell Run/Walk. In addition, the Arthritis Foundation hosts dinners, galas and specialty parties, from traditional black-tie galas and tribute dinners to wine tastings and themed parties that benefit the Foundation's efforts. Through community

title: Arthritis

text: is acetaminophen (paracetamol) while for inflammatory arthritis it involves non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. Opioids and NSAIDs are less well tolerated. Rheumatoid arthritis (RA) is autoimmune so, in addition to pain medications and anti-inflammatory drugs, is treated with another category of drug called disease-modifying antirheumatic drugs (DMARDs), which act on the immune system to slow down the progression of RA. An example of this type of drug is methotrexate. A number of rheumasurgical interventions have been incorporated in the treatment of arthritis since the 1950s. Arthroscopic surgery for osteoarthritis of the knee provides no additional benefit to optimized physical

title: Rheumatoid arthritis

text: (known as rheumatoid nodules); this is associated with a poor prognosis. Poor prognostic factors include, RA reduces lifespan on average from three to twelve years. Young age at onset, long disease duration, the presence of other health problems, and characteristics of severe RA—such as poor functional ability or overall health status, a lot of joint damage on x-rays, the need for hospitalisation or involvement of organs other than the joints—have been shown to associate with higher mortality. Positive responses to treatment may indicate a better prognosis. A 2005 study by the Mayo Clinic noted that RA sufferers suffer a doubled

title: Rheumatoid arthritis

text: which controls recognition of self versus nonself molecules; other mutations affecting co-stimulatory immune pathways, for example CD28 and CD40), cytokine signaling, lymphocyte receptor activation threshold (e.g., PTPN22), and innate immune activation appear to have less influence than HLA mutations. There are established epigenetic and environmental risk factors for RA. Smoking is an established risk factor for RA in Caucasian populations, increasing the risk three times compared to non-smokers, particularly in men, heavy smokers, and those who are rheumatoid factor positive. Modest alcohol consumption may be protective. Silica exposure has been linked to RA. No infectious agent has been consistently linked

title: Septic arthritis

text: 1.1% of getting infected in knee joint, and 0.3 to 1.7% of getting infected in hip joint. There are three phases of artificial joint infection: early, delayed, and late. Septic arthritis is most commonly caused by bacteria reaching the synovial membrane of a joint. Bacteria can enter the joint by: Micro-organisms in the blood may come from infections elsewhere in the body such as wound infections, urinary tract infections, meningitis , or endocarditis. Sometimes the infection comes from an unknown location. Joints with preexisting arthritis, such as rheumatoid arthritis, are especially prone to bacterial arthritis spread through the blood. In

title: Arthritis mutilans

text: a greater extent of marrow edema, expanding to diaphysis. The bone edema in arthritis mutilans can be treated with TNF inhibitors in the short term: a 2007 study found that the bone edema associated with psoriatic arthritis (of which arthritis mutilans is a subtype) responded to TNF inhibitors with "dramatic" improvement, but the study was not determinative of whether TNF inhibitors would prevent new bone formation, bone fusion, or osteolysis (bone resorption). Although a 2011 research article stated that disagreements between hand surgeons and rheumatologists remain regarding the indications, timing and effectiveness of rheumatoid hand surgery, arthritis mutilans may be

title: Post-traumatic arthritis

text: inflammatory arthritis, accounting for between 2 and 25% of all post-traumatic arthritis cases. There are reports about a connection between previous physical injury and inflammatory arthritis, such as rheumatoid arthritis or psoriatic arthritis. The symptoms of post-traumatic arthritis are similar to the ones occurring with osteoarthritis. General symptoms are stiffness, swelling, synovial effusion, pain, redness, tenderness, grinding, instability and intra-articular bleeding of the injured joint. As a result of this symptoms, post-traumatic arthritis often comes along with the loss of ability. Since post-traumatic arthritis usually occurs after injuring a joint, the risk of having post-traumatic arthritis after such an injury

title: Rheumatoid arthritis

text: arthritis. People with RA have an increased risk of infections and mortality and recommended vaccinations can reduce these risks. The inactivated influenza vaccine should be received annually. The pneumococcal vaccine should be administered twice for people under the age 65 and once for those over 65. Lastly, the live-attenuated zoster vaccine should be administered once after the age 60, but is not recommended in people on a tumor necrosis factor alpha blocker. The course of the disease varies greatly. Some people have mild short-term symptoms, but in most the disease is progressive for life. Around 20%–30% will have subcutaneous nodules

title: Arthritis mutilans

text: in arthritis mutilans and correlate with radiographic measures of joint damage, although they may not correlate with disease activity. A source of significant pain, bone marrow edema (or lesions, using newer terminology), can be detected on MRI or with ultrasonography by signals of excessive water in bone marrow. Specifically, bone marrow edema can be detected within bone on T1-weighted images as poorly defined areas of low signal, with a high signal on T2-weighted fat-suppressed images. Comparatively, with arthritis mutilans in "rheumatoid arthritis", bone marrow edema often involves the bone layer, while the condition as a subtype of "psoriatic arthritis" includes

title: Arthritis

text: arthritis (RA) is a disorder in which the body's own immune system starts to attack body tissues. The attack is not only directed at the joint but to many other parts of the body. In rheumatoid arthritis, most damage occurs to the joint lining and cartilage which eventually results in erosion of two opposing bones. RA often affects joints in the fingers, wrists, knees and elbows, is symmetrical (appears on both sides of the body), and can lead to severe deformity in a few years if not treated. RA occurs mostly in people aged 20 and above. In children, the

title: Rheumatoid arthritis

text: arthritis. Disease-modifying antirheumatic drugs (DMARDs) are the primary treatment for RA. They are a diverse collection of drugs, grouped by use and convention. They have been found to improve symptoms, decrease joint damage, and improve overall functional abilities. DMARDs should be started early in the disease as they result in disease remission in approximately half of people and improved outcomes overall. The following drugs are considered as DMARDs: methotrexate, hydroxychloroquine, sulfasalazine, leflunomide, TNF-alpha inhibitors (certolizumab, infliximab and etanercept), abatacept, and anakinra. Rituximab and tocilizumab are monoclonal antibodies and are also DMARDs. Hydroxychloroquine, apart from its low toxicity profile, is considered

title: Arthritis

text: causes the two opposing bones to erode into each other. The condition starts with minor pain during physical activity, but soon the pain can be continuous and even occur while in a state of rest. The pain can be debilitating and prevent one from doing some activities. Osteoarthritis typically affects the weight-bearing joints, such as the back, knee and hip. Unlike rheumatoid arthritis, osteoarthritis is most commonly a disease of the elderly. More than 30 percent of women have some degree of osteoarthritis by age 65. Risk factors for osteoarthritis include prior joint trauma, obesity, and a sedentary lifestyle. Rheumatoid

title: Rheumatoid arthritis

text: started. The by far most common clinical test for ACPAs is the anti-cyclic citrullinated peptide (anti CCP) ELISA. In 2008 a serological point-of-care test for the early detection of RA combined the detection of RF and anti-MCV with a sensitivity of 72% and specificity of 99.7%. Other blood tests are usually done to differentiate from other causes of arthritis, like the erythrocyte sedimentation rate (ESR), C-reactive protein, full blood count, kidney function, liver enzymes and other immunological tests (e.g., antinuclear antibody/ANA) are all performed at this stage. Elevated ferritin levels can reveal hemochromatosis, a mimic of RA, or be a

title: Arthritis

text: tests such as radiology and blood tests, depending on the type of suspected arthritis. All arthritides potentially feature pain. Pain patterns may differ depending on the arthritides and the location. Rheumatoid arthritis is generally worse in the morning and associated with stiffness lasting over 30 minutes. However, in the early stages, patients may have no symptoms after a warm shower. Osteoarthritis, on the other hand, tends to be associated with morning stiffness which eases relatively quickly with movement and exercise. In the aged and children, pain might not be the main presenting feature; the aged patient simply moves less, the

title: Septic arthritis

text: addition, some treatments for rheumatoid arthritis can also increase a patient's risk by causing an immunocompromised state. Intravenous drug use can cause endocarditis that spreads bacteria in the bloodstream and subsequently causes septic arthritis. Bacteria can enter the joint directly from prior surgery, intraarticular injection, trauma, or joint prosthesis. The rate of septic arthritis varies from 4 to 29 cases per 100,000 person-years, depending on the underlying medical condition and the joint characteristics. For those with septic joint, 85% of the cases have an underlying medical condition while 59% of them had a previous joint disorder. Having more than one

title: Arthritis

text: fibromyalgia, and septic arthritis. They are all types of rheumatic disease. Treatment may include resting the joint and alternating between applying ice and heat. Weight loss and exercise may also be useful. Pain medications such as ibuprofen and paracetamol (acetaminophen) may be used. In some a joint replacement may be useful. Osteoarthritis affects more than 3.8% of people while rheumatoid arthritis affects about 0.24% of people. Gout affects about 1–2% of the Western population at some point in their lives. In Australia about 15% of people are affected, while in the United States more than 20% have a type of

title: Knee arthritis

text: obesity, heredity, joint injury or stress, and aging. Cartilage in the knee may begin to break down after sustained stress from prolonged standing or walking, leaving the bones of the knee rubbing against each other. Persons who work in a place that applies repetitive stress on the knees are at a high risk of developing this condition. Bone deformities increase the risk for osteoarthritis of the knee since the joints are already malformed and may contain defective cartilage. Having gout, rheumatoid arthritis, Paget's disease of bone or septic arthritis may increase a person's risk of developing osteoarthritis. It is believed

title: Juvenile idiopathic arthritis

text: go. Fever can occur at the same time every day or twice a day (often in late afternoon or evening) with a spontaneous rapid return to baseline (vs. septic arthritis of continuous fever). The rash is discrete, salmon-pink macules of different sizes. It migrates to different locations on skin, rarely persisting in one location more than one hour. The rash is commonly seen on trunk and proximal extremities or over pressure areas. Systemic JIA may have internal organ involvement - hepatosplenomegaly, lymphadenopathy, serositis, hepatitis, tenosynovitis, etc. It is also known as "systemic onset juvenile rheumatoid arthritis". A polymorphism in macrophage

title: Juvenile idiopathic arthritis

text: from the preschool years to the early teenaged years. Juvenile idiopathic arthritis affects between eight and 150 of every 100,000 children, depending on the analysis. Of these children, 50% have pauciarticular JIA, 40% have polyarticular JIA, and 10% have systemic JIA. In a preselected group (children under 16 years with orthodontic treatment need), prevalence rises to one out of 100 (0.88% out of 1024 children). The terminology used is evolving, and each term has some limitations. According to some sources, JIA replaces the term juvenile rheumatoid arthritis (JRA). Other sources still use the latter term. JIA is sometimes referred to

title: National Institute of Arthritis and Musculoskeletal and Skin Diseases

text: in normal and disease states, leading to PDCTC for rheumatic and related diseases. Research is managed under two main areas: Arthritis and Rheumatic Diseases—advance clinical biomedical and biopsychosocial PDCTC research for arthritis and rheumatic diseases. This includes work that advances the understanding of the natural history of these disorders, as well as mechanisms of disease susceptibility and development. The programs support research in rheumatoid arthritis; adjuvant and chemically induced inflammatory arthritis; systemic lupus erythematosus; systemic scleroderma; spondyloarthropathies; dermatomyositis and myositis; vasculitis; fibromyalgia; juvenile arthritis and general autoimmunity; gout; Lyme disease; and infection-related arthritis. Research incorporates advances in genetics, genomics, proteomics,

title: Rheumatoid nodule

text: size from that of a lentil or pea to that of a mandarin orange. Quite often they are associated with synovial pockets or bursae. About 5% of rheumatoid arthritis patients have such nodules within two years of disease onset, and the cumulative prevalence is about 25%. In the great majority of cases nodules are not painful or disabling in any way, being more of an unsightly nuisance, but in some cases they can be painful, especially if the overlying skin breaks down. Rarely, the nodules occur at diverse sites on body (e.g. upper eyelid, distal region of the soles of

title: Juvenile idiopathic arthritis

text: of the body (such as both wrists.) Children with polyarticular JIA are also at risk for developing chronic iridocyclitis or uveitis and should also be monitored by an optometrist or ophthalmologist. Rheumatoid factor may be positive, i.e. seropositive, in children with polyarticular JIA occurring between 9 and 16 years of age and is associated with" HLA DR4" and "HLA DW4". This group has poorer prognosis with about 50% progressing to severe disabiling arthritis, persisting into adulthood. It is generally seronegative in JIA occurring below 10 years of age with a milder disease process and responds better to treatment. Seropositivity is

title: Juvenile idiopathic arthritis

text: other causes of differential expression of genes. Experimental studies have shown that certain mutated viruses may be able to trigger JIA. The disease appears to be more common in girls, and the disease is most common in Caucasians. Associated factors that may worsen or have been linked to rheumatoid arthritis include: The cause of JIA, as the word "idiopathic" suggests, is unknown and an area of active research. Current understanding of JIA suggests that it arises in a genetically susceptible individual due to environmental factors. Diagnosis of JIA is difficult because joint pain in children can be from many other

title: Arthritis

text: first known traces of human arthritis date back as far as 4500 BC. In early reports, arthritis was frequently referred to as the most common ailment of prehistoric peoples. It was noted in skeletal remains of Native Americans found in Tennessee and parts of what is now Olathe, Kansas. Evidence of arthritis has been found throughout history, from Ötzi, a mummy (circa 3000 BC) found along the border of modern Italy and Austria, to the Egyptian mummies circa 2590 BC. In 1715, William Musgrave published the second edition of his most important medical work, "De arthritide symptomatica", which concerned arthritis

title: Mutated citrullinated vimentin

text: greater than that of rheumatoid factor. Recently a serological point-of-care test (POCT) for the early detection of RA has been developed. This assay combines the detection of rheumatoid factor and anti-MCV for diagnosis of rheumatoid arthritis and shows a sensitivity of 72% and specificity of 99.7%. Anti-MCV are used as efficient biomarkers for estimating progress of rheumatoid arthritis. Main advantage of testing for anti-MCV is the early appearance of the anti-MCV antibodies, what allows for detection of early RA and submits adequate therapy just after the disease’s onset. Moreover, anti-MCV titres show strong correlation to disease activity, disease severity and

title: John Cosh

text: John Cosh John Cosh (1915–2005) was a British rheumatologist. He is known for his long term studies of the effects of rheumatoid arthritis, co-discovery of the genes associated with rheumatoid arthritis, and his work on the benefits of herbal medicines. In 1973, with R K Jacoby and M I Jayson, he published an 11-year follow-up of 100 patients newly diagnosed as having rheumatoid arthritis and followed them for a further 30 years, showing that rheumatoid arthritis is a progressive disease impairing function for decades after onset. By 2004 eight of the sample were severely disabled with rheumatoid arthritis, three were

title: Rheumatoid arthritis

text: hands show, in the opinion of some physicians, increasing deformity consistent with the symptoms of the disease. RA appears to some to have been depicted in 16th-century paintings. However, it is generally recognized in art historical circles that the painting of hands in the 16th and 17th century followed certain stylized conventions, most clearly seen in the Mannerist movement. It was conventional, for instance, to show the upheld right hand of Christ in what now appears a deformed posture. These conventions are easily misinterpreted as portrayals of disease. Historic treatments for RA have also included: rest, ice, compression and elevation,

title: Rheumatoid lung disease

text: exposed to coal dust. 1954, rheumatoid lung nodules were found in patients with RA who were not exposed to coal dust and without pneumoconiosis. 1955 there was a short case series of about 10 patients with RA whose autopsies showed that the pleural disease was much higher in rheumatoid patients than in the general population, and much higher than what they had previously seen clinically. 1961, Cudkowicz described the first pulmonary function tests and lung biopsies were done in RA patients. RA is a complex and poorly understood disease. However, the characteristic presence of antibodies to citrullinated proteins (anti-CCP) suggests

title: Arthritis Australia

text: Arthritis Australia, originally named the Australian Rheumatism Council, held its inaugural meeting on 25 May 1949. Its objectives were to: In 1968 the name was changed to Australian Arthritis and Rheumatism Foundation and in 1984 the foundation incorporated in New South Wales and became the Arthritis Foundation of Australia. From 1948 through the 1950s, individual physicians who were interested in the management of rheumatic conditions were at disadvantage as there were few facilities at the teaching hospitals. There was also widespread ignorance among the general public as to what could be done for people with arthritis. In 1960 the foundation

title: HLA-DR1

text: microbial antigens. DRB1*0102 is associated with rheumatoid arthritis, in anti-Jk(a) mediated hemolytic transfusion reactions, psoriasis vulgaris, and recurrent respiratory papillomatosis DRB1*0103 is associated with colonic Crohn's disease and ulcerative colitis. DRB1*0101/*0404 and *0101/*0401 increases risk of mortality in rheumatoid arthritis, with eschemic heart disease and smoking. these same genotypes are associated with rheumatoid vasculitis. DRB1*0102:DQB1*0501 is associated with psoriasis vulgaris and tubulointerstitial nephritis & uveitis syndrome, but is relatively protective against juvenile diabetes. DR1-DQ5 is associate with tubulointerstitial nephritis & uveitis syndrome. DR1 are associated with rheumatoid arthritis, and while not the strongest association with the highest risk for early

title: HLA-DR4

text: *01:01/*04:01 increases risk of mortality in rheumatoid arthritis, with ischemic heart disease and smoking. these same genotypes are associated with rheumatoid vasculitis. HLA-DR4 HLA-DR4 (DR4) is an HLA-DR serotype that recognizes the DRB1*04 gene products. The DR4 serogroup is large and has a number of moderate frequency alleles spread over large regions of the world. The serological identification of DR4 is good. The serology of DRB1*04:17 to *04:60 is unknown. DR4 is associated with extraarticular rheumatoid arthritis, hydralazine-induced female systemic lupus erythematosus, pemphigoid gestationis, pemphigus foliaceus, obstructive hypertrophic cardiomyopathy, IgA nephropathy, 'shared syndrome'-systemic sclerosis/rheumatoid arthritis and polymyalgia rheumatica. DRB1*04 is

title: HLA-DR4

text: HLA-DR4 HLA-DR4 (DR4) is an HLA-DR serotype that recognizes the DRB1*04 gene products. The DR4 serogroup is large and has a number of moderate frequency alleles spread over large regions of the world. The serological identification of DR4 is good. The serology of DRB1*04:17 to *04:60 is unknown. DR4 is associated with extraarticular rheumatoid arthritis, hydralazine-induced female systemic lupus erythematosus, pemphigoid gestationis, pemphigus foliaceus, obstructive hypertrophic cardiomyopathy, IgA nephropathy, 'shared syndrome'-systemic sclerosis/rheumatoid arthritis and polymyalgia rheumatica. DRB1*04 is associated with increased risk for alopecia areata. DRB1*04:01 is associated with multiple sclerosis, rheumatoid arthritis, type 1 diabetes, lyme disease induced arthritis.

title: Arthritis Australia

text: most basic daily tasks such as walking, driving a car and preparing food. Arthritis is not yet curable. While the condition is usually manageable, it invariably impacts on a person’s quality of life and includes varying degrees of discomfort and pain. Arthritis Australia Arthritis Australia was founded in 1949 (as the Australian Arthritis and Rheumatism Foundation) and is the peak body in Australia for arthritis and musculoskeletal conditions. Arthritis Australia is a charitable not-for-profit organisation, and dedicated to bringing quality of life to all people with arthritis and musculoskeletal conditions and eliminating their suffering, by Arthritis Australia is supported by

title: Arthritis Australia

text: Arthritis Australia Arthritis Australia was founded in 1949 (as the Australian Arthritis and Rheumatism Foundation) and is the peak body in Australia for arthritis and musculoskeletal conditions. Arthritis Australia is a charitable not-for-profit organisation, and dedicated to bringing quality of life to all people with arthritis and musculoskeletal conditions and eliminating their suffering, by Arthritis Australia is supported by affiliate offices in ACT, New South Wales, Northern Territory, Queensland, South Australia, Tasmania and Western Australia. With an ageing and increasingly obese population, the number of people with arthritis is growing, especially as obesity is the major risk factor for osteoarthritis.

title: Arthritis

text: which can lead to secondary effects, such as: These changes, in addition to the primary symptoms, can have a huge impact on quality of life. Arthritis is the most common cause of disability in the United States. More than 20 million individuals with arthritis have severe limitations in function on a daily basis. Absenteeism and frequent visits to the physician are common in individuals who have arthritis. Arthritis can make it very difficult for individuals to be physically active and some become home bound. It is estimated that the total cost of arthritis cases is close to $100 billion of