What are the causes and diagnosis of rheumatoid arthritis?

Written by: Dr. Jesús Tornero Molina
Edited by: Anna Raventós Rodríguez

Rheumatoid arthritis is an inflammatory joint disease that causes the swelling and pain, in addition to functional disability. This pathology is characterized by:

  • Chronic, ie, symptoms persist for months / years if not acted upon;
  • Polyarticular usually affects multiple joints, especially the small joints of the hands and feet; wrists, elbows, shoulders, hips, knees and ankles.
  • Potentially erosive; this means that the inflammation of the joints can act (if its effect is not mitigated) as woodworm and dissolve and break the bone of the joint, deforming.

The disease occurs most often in women, in middle age of life (30-50 years), but you can also see cases in men and in older ages. In some patients, and arthritis may occur general symptoms (fever or feverishness, tiredness and easy fatigue, loss of appetite), along with extra-articular findings in skin, lung, heart and eyes. Generally, rheumatoid arthritis does not affect the lumbar spine.


Rheumatoid Arthritis: Causes

The exact cause of rheumatoid arthritis is unknown, but is thought to be the result of the action of an environmental agent (probably a microbe, or part thereof) acting on a certain susceptible organism, carrier of certain genetic characteristics.

Patients with rheumatoid arthritis often have in their immediate family other relatives suffering from the same disease or other forms of arthritis related. Other risk factors include snuff and poor hygiene orodental. Thus, periodontal disease may contribute to the onset of the disease.

Microscope view with chronic inflammation in a nodule reumatoid e.


Whatever the precipitating agent, resulting in a dysregulation of the immune system of the person; thus the body itself fails to recognize as their own are substances and produces antibodies against them which cause chronic inflammation, commonly in joints.

What it is the first inflamed synovium articulate a structure which produces synovial fluid, which acts as a lubricant fluid and nutrient of the other components of the joint. When ignited this membrane swells and increases the size of the joint. Inflammation causes the output of more liquid and subsequent joint effusion. Finally, this process can release, capable of destroying the other components of the joint, especially the cartilage and bone very harmful substances type enzyme.


Rheumatoid Arthritis: Symptoms

Rheumatoid arthritis painless enlargement of joints. The pain is continuous: it appears when the joint is mobilized but also at rest. You can become very intense during sleep and is accompanied by characteristic form of generalized morning stiffness, which disappears during the day as the physical activity of the day unfolds.

joint swelling
5th joint inflammation in rheumatoid finger and subcutaneous nodule on the 3rd finger.


Inflammation is usually located in the hands, knees, and feet. The end joints of the knuckles of the fingers and spine (except sometimes the cervical spine) are not affected ever.

In addition, symptoms of general involvement, as a feeling of fever, fatigue, muscle pain, eye or skin involvement (nodules) can occur.


Rheumatoid arthritis: diagnosis

The most important are the symptoms reported by the patient and the doctor finds that finds in exploration. It is therefore important that in case of doubt , consult a specialist in rheumatology to cast his expert opinion.

X-feet to visualize multiple joint erosions in a patient withrheumatoid arthritis.


Some analyzes are very useful to confirm the existence of inflammation (C - reactive protein) and determine that it could be related to rheumatoid arthritis (rheumatoid factor, antibodies against cyclic citrullinated peptides). If you get withdrawing fluid from a joint with effusion that can help the diagnosis.

Radiology can also help visualizing the joint erosions disease characteristics.

On the other hand, we must differentiate between rheumatoid arthritis from other forms of arthritis (gout, pseudogout, psoriatic arthritis, ankylosing spondylitis) and osteoarthritis (especially osteoarthritis of the hands).


Rheumatoid arthritis: treatment

It is very important to diagnose the disease as soon as possible and act energetically on it to immediately control inflammation and prevent irreversible damage appears articular. Today we have a broad array of therapeutic measures potentially capable of eliminating pain and joint inflammation, preventing joint damage and disability. These include mainly include methotrexate, leflunomide, the anti-TNF biologics, abatacept, rituximab and tocilizumab.


Rheumatoid arthritis Forecast

Not knowing its final cause, the disease can not be prevented. For this reason it is very important to early diagnosis. Early therapeutic intervention, close to the date of the first symptoms, very useful and greatly improves prognosis.

It is important to follow the advice and instructions of your doctor and make follow - up visits and tests will indicate. It is fully demonstrated that in rheumatoid arthritis, the narrower is the medical and close monitoring of the disease, the better the prognosis and outcome of medical action.

*Translated with Google translator. We apologize for any imperfection

By Dr. Jesús Tornero Molina

Dr. Jesús Tornero Molina is a renowned specialist in Rheumatology, an expert in the pathologies of arthritis, osteoarthritis, osteoporosis, spondylitis, rheumatic polymagia and collagen, among others. He is head of the Rheumatology section at the Guadalajara University Hospital since 1987. He has had his own private practice since 2001. He combines his professional work with teaching, being an associate professor of Medicine at the University of Alcalá since 1988. He also , has been President of the Spanish Society of Rheumatology.

In his more than 34 years of experience in the treatment of rheumatic diseases, he has treated more than 200,000 patients.

*Translated with Google translator. We apologize for any imperfection

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