A systemic disease that affects connective tissue, and of which arthritis is the dominant clinical manifestation. It involves many joints (particularly hands and feet) accompanied by the thickening of articular soft tissue, with extension of the synovial tissue over articular cartilages, which become eroded.
Rheumatoid arthritis is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks synovial joints (a freely movable joint, where the ends of the bone are covered with cartiledge, and linked by a ligament lined with synovial membranes which secrete synovial fluid). The process produces an inflammatory response of the synovium (synovitis) secondary to hyperplasia of synovial cells, excess synovial fluid, and the development of pannus in the synovium. The pathology of the disease process often leads to the destruction of articular cartilage and ankylosis of the joints. Rheumatoid arthritis can also produce diffuse inflammation in the lungs, pericardium, pleura, and sclera, and also nodular lesions, most common in subcutaneous tissue. Although the cause of rheumatoid arthritis is unknown, autoimmunity plays a pivotal role in both its chronicity and progression, and rheumatoid arthritis is considered a systemic autoimmune disease.
Various treatments are available. Non-pharmacological treatment includes physical therapy, orthoses, occupational therapy and nutritional therapy but do not stop progression of joint destruction. Analgesia (painkillers) and anti-inflammatory drugs, including corticosteroids, are used to suppress the symptoms, while disease-modifying anti-rheumatic drugs (DMARDs) are required to inhibit or halt the underlying immune process and prevent long-term damage. In recent times, the newer group of biologics has increased treatment options.