Reumatoid

Reumatoid, commonly called rheumatoid arthritis (RA), is a chronic autoimmune inflammatory disease that primarily affects joints. It most often presents with symmetric swelling, pain, and stiffness in the hands and wrists, with morning stiffness lasting over an hour. Fatigue, and sometimes fever, may accompany joint symptoms. In some patients, inflammation affects other tissues, including the eyes and lungs.

The disease is driven by autoimmunity. Antibodies such as rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA) are often present. Inflammation is driven by cytokines like TNF-α, IL-1, and IL-6, leading to synovial thickening (pannus) and progressive joint damage, including cartilage loss and bone erosions. Genetics and environmental factors, notably smoking, increase risk.

Diagnosis relies on clinical features, serology (RF, ACPA), inflammatory markers (ESR or CRP), and imaging. The 2010 ACR/EULAR criteria guide classification, and ultrasound or MRI can detect early synovitis; X‑rays reveal erosions later.

Treatment aims to induce remission or low disease activity and to prevent damage. The cornerstone is disease-modifying antirheumatic drugs (DMARDs), with methotrexate as first line. Other conventional DMARDs include leflunomide, sulfasalazine, and hydroxychloroquine. Biologic DMARDs targeting TNF or other pathways, and small molecule JAK inhibitors, are used when response is inadequate. Glucocorticoids may be used short term to control flares. Nonpharmacologic care, including physical and occupational therapy and regular exercise, supports function.

Prognosis varies. Early, effective treatment improves outcomes, but some patients develop persistent arthritis and disability despite therapy. Management is individualized, considering comorbidities such as cardiovascular disease and infection risk.