page_title: Arthritis
section_title: Rheumatoid arthritis
hierarchical_section_title: Arthritis / Diagnosis / Rheumatoid arthritis
caption_attribution_description: English: X-ray of right fourth proximal interphalangeal (PIP) joint with bone erosions by rheumatoid arthritis. Taken October 2002. Same joint is partially healed on a follow-up X-ray after treatment with conventional disease-modifying antirheumatic drugs(DMARDs) one year later: File:X-ray of right fourth PIP joint with partially healed bone erosions by rheumatoid arthritis.jpg
context_page_description: 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 of arthritis, other organs are also affected. Onset can be gradual or sudden.
  There are over 100 types of arthritis. The most common forms are osteoarthritis 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, 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. Recommended medications may depend on the form of arthritis. These may include pain medications such as ibuprofen and paracetamol. In some circumstances, a joint replacement may be useful.
  Osteoarthritis affects more than 3.8% of people while rheumatoid arthritis affects about 0.24% of people.
context_section_description: Rheumatoid 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 disorder can present with a skin rash, fever, pain, disability, and limitations in daily activities. With earlier diagnosis and aggressive treatment, many individuals can lead a better quality of life than if going undiagnosed for long after RA's onset. The risk factors with the strongest association for developing rheumatoid arthritis are female sex, family history of rheumatoid arthritis, and exposure to tobacco smoke.
  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 and osteoblasts. Osteoclast activity can be directly induced by osteoblasts through the RANK/RANKL mechanism.
caption: Bone erosions by rheumatoid arthritis.[31]
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