Rheumatoid Arthritis of the Hand

What is Rheumatoid Arthritis (RA)?

RA is a chronic autoimmune disease that causes pain, swelling, stiffness, and loss of function in the affected joints. The hands are especially likely to suffer with this painful disease because there are 25 joints in each hand. RA commonly affects the smaller joints in the body first, and then progresses to the major joints.

RA usually begins in middle age and is much more common in women than men. While rare, there is a juvenile form of RA. RA progresses slowly but once joint damage is done, it cannot be reversed.

What causes RA?

RA is an autoimmune disease. An autoimmune disease is when the immune system attacks healthy tissue. The cartilage that covers the ends of the bones is designed to support and protect the joint. Under the cartilage is a synovial membrane which produces a substance that lubricates the joint for easy movement, and provides nutrition to the cartilage.

The cause is unknown. But the risk of getting RA involves genetic factors, including a gene named HLA which makes people predisposed to developing RA. RA runs in families.

Environment factors, like infection, air pollution, insecticides, and occupational exposure to mineral oils and silica, when coupled with a genetic predisposition create an even greater risk of developing RA.

In RA, white blood cells cause the synovial membrane to inflame, causing the joints to thicken and swell, causing painful movement. The constant inflammation leads to erosion of the joint, destroys the cartilage and bones, resulting in joint damage and loss of motion. As the condition worsens, the pain and stiffness worsen.

What are the symptoms of RA?

Typical symptoms are:

• Fatigue
• Low fever
• Skin rash
• Muscle aches
• Morning stiffness
• Weight loss
• Joint pain, swelling, stiffness and loss of function as the support for the joint weakens.

Severe inflammation is called a flare up.  This is when the affected joints become red, swollen and warm. And, the symptoms are symmetrical meaning the same joints on both sides of the body are affected at the same time.

How is Hand RA diagnosed?

The first signs of RA appear in the smallest joints. Your Ortho Illinois physician will evaluate your symptoms, including your family history, and the history of your pain.  The joints will be examined and blood tests will be ordered. Imaging tests will be used to detect and evaluate joint damage.

Treatment involves medications to modify the course of the disease, reduce inflammation, prevent continued damage, and improve quality of life.