Rheumatoid

Rheumatoid, in medical usage, most often refers to rheumatoid arthritis (RA), a chronic autoimmune inflammatory disease that principally affects the joints but can involve other tissues. RA characteristically causes symmetric pain and swelling in the hands, wrists, and feet, with morning stiffness lasting more than 30 minutes. Fatigue and reduced function are common.

Pathophysiology: an autoimmune attack on the synovial lining leads to chronic synovitis, pannus formation, and progressive cartilage and bone erosion. Serological markers such as rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA) support the diagnosis, and inflammatory markers (ESR, CRP) rise during flares. RA can have extra-articular manifestations, including nodules, lung or eye involvement, anemia, and vasculitis.

Diagnosis: based on clinical features, serology, inflammatory markers, and imaging. The ACR/EULAR criteria help distinguish RA from other arthritides. Early recognition is important to prevent joint damage.

Treatment and management: goal is remission or low disease activity. First-line therapy typically includes disease-modifying antirheumatic drugs (DMARDs), especially methotrexate. Biologic or targeted synthetic DMARDs (for example TNF inhibitors) are added if needed. Corticosteroids may be used for short-term control; NSAIDs relieve pain. Non-pharmacologic approaches include physical therapy and smoking cessation.

Prognosis and epidemiology: prevalence is around 0.5–1% of the population with a female predominance (approximately 3:1). Outcomes improve with early, aggressive treatment, but the course varies and may involve joint damage and extra-articular disease in some patients.