Rheumatoid

Arthritis(RA)

Dr. Tola FARAJ Ms. Chnar Hussam

What is rheumatoid arthritis (RA)?

▪ Rheumatoid arthritis, or RA, is an autoimmune and inflammatory disease,which means that your immune system attacks healthy cells in your body bymistake, causing inflammation (pain, swelling ….?) in the affected parts of thebody.

▪ RA mainly attacks the joints, usually many joints at once. RA commonly affectsjoints in the hands, wrists, and knees. In a joint with RA, the lining of the jointbecomes inflamed, causing damage to joint tissue. This tissue damage cancause long-lasting or chronic pain, unsteadiness (lack of balance), anddeformity (misshapenness).

▪ RA can also affect other tissues throughout the body and cause problems inorgans such as the lungs, heart, and eyes.

The meniscus is a piece of cartilage that provides a cushion betweentwo bones in the joint.

Synovial fluid, also called synovia, isa fluid found in the cavities ofsynovial joints. With its egg white-like consistency, the principle role ofsynovial fluid is to reduce frictionbetween the articular cartilage ofsynovial joints during movement.

What are the signs and symptoms of RA?With RA, there are times when symptoms get worse, known as flares, and times whensymptoms get better, known as remission.

Signs and symptoms of RA include:

▪ Pain in more than one joint

▪ Stiffness in more than one joint

▪ Swelling in more than one joint

▪ The same symptoms on both sides of the body (such as in both hands or both knees)

▪ Weight loss

▪ Fever

▪ Fatigue or tiredness

▪ Weakness

▪ RA nodules

What causes RA?

▪ RA is the result of an immune response inwhich the body’s immune system attacks itsown healthy cells. The specific causes of RA areunknown, but some factors can increase therisk of developing the disease.

▪ Researchers have studied a number of geneticand environmental factors to determine if theychange person’s risk of developing RA.

▪ Age_ RA can begin at any age, but the likelihoodincreases with age. The onset of RA is highestamong adults in their sixties.

▪ Sex_ New cases of RA are typically two-to-threetimes higher in women than men.

▪ Genetics/inherited traits_ People born withspecific genes are more likely to develop RA.These genes, called HLA (human leukocyteantigen) class II genotypes, can also make yourarthritis worse. The risk of RA may be highestwhen people with these genes are exposed toenvironmental factors like smoking or when aperson is obese.

▪ Smoking_ Multiple studies show that cigarette smokingincreases a person’s risk of developing RA and can make thedisease worse.

▪ History of live births_ Women who have never given birth maybe at greater risk of developing RA.

▪ Early Life Exposures_ Some early life exposures may increaserisk of developing RA in adulthood. For example, one studyfound that children whose mothers smoked had double the riskof developing RA as adults. Children of lower income parentsare at increased risk of developing RA as adults.

▪ Obesity_ Being obese can increase the risk of developing RA.Studies examining the role of obesity also found that the moreoverweight a person was, the higher his or her risk ofdeveloping RA became.

What are the complications of RA?

Rheumatoid arthritis (RA) has many physical andsocial consequences and can lower quality oflife. It can cause pain, disability, and prematuredeath.

▪ Premature heart disease_ People with RA arealso at a higher risk for developing other chronicdiseases such as heart disease and diabetes. Toprevent people with RA from developing heartdisease, treatment of RA also focuses onreducing heart disease risk factors. For example,doctors will advise patients with RA to stopsmoking and lose weight.

What are the complications of RA?

▪ Obesity_ People with RA who areobese have an increased risk ofdeveloping heart disease risk factorssuch as high blood pressure and highcholesterol. Being obese also increasesrisk of developing chronic conditionssuch as heart disease and diabetes.Finally, people with RA who are obeseexperience fewer benefits from theirmedical treatment compared withthose with RA who are not obese.

What are the complications of RA?

▪ Employment_ RA can make workdifficult. Adults with RA are less likelyto be employed than those who donot have RA. As the disease getsworse, many people with RA findthey cannot do as much as they usedto. Work loss among people with RAis highest among people whose jobsare physically demanding. Work lossis lower among those in jobs with fewphysical demands, or in jobs wherethey have influence over the job paceand activities.

Diagnosis of Rheumatoid Arthritis (RA)▪ X-rays can be helpful in detecting RA.

▪ Further, MRI and ultrasound scanning can be done to help confirm oranalyze the severity of RA.

Blood Test for Diagnosis of RA▪ Rheumatoid Factor test_ The RA Factor blood test checks the level of a

protein known as the rheumatoid factor. Increased levels ofrheumatoid factor can be a sign of autoimmune diseases, especiallyRA.

▪ C-reactive protein test_ A severe infection or remarkable inflammation,anywhere in the body, can trigger the liver to produce C-reactiveprotein. High levels of C- reactive protein can be associated with RA.

▪ Erythrocyte Sedimentation Rate_ The ESR test helps in determining thedegree of inflammation in the body. The result of ESR helps the doctorto see whether inflammation is present. However, the test does notindicate the cause of the inflammation.

▪ Antinuclear antibody test_ The antinuclear antibody examines theimmune system to see if it’s producing antibodies. The human bodyproduces several antibodies as a response to many diseases, includingRA.

RA rapid agglutination latex test kit

Principle of RA latex test

Result reading ▪ Reading_▪ Non-reactive: Smooth suspension with no visible agglutination, as shown by

negative control.▪ Reactive: Any degree of agglutination visible macroscopically.

▪ Agglutination reaction for latex reagent with Positive control, Negative controland Test sample_

Circle 1: Positive Control Circle 2: Test sample Circle 3: Negative Control

False positive result

▪ Bacterial contamination of controls and specimens as well as freezingand thawing of the RF-Latex Reagent may lead to false positive results.

▪ Traces of detergent in the test cards may give false positive results.Wash used cards first under tap water until all reactants are removedand then with distilled water. Allow to air dry, avoiding the use oforganic solvents as they may impair the special finish on the slide.

▪ The RF-Latex Reagent must not be used beyond its expiry datebecause a prolonged storage can affect the sensitivity of thesuspension.

T H A N K S