What is Rheumatoid Arthritis?

Unfortunately, unlike when it's fighting the common cold, your immune system never wins these battles, and the pain becomes chronic.

No one knows why our immune system might recognize our own body parts as foreign objects. But there are a few theories, reigniting the old nature vs. nurture debate. Here's what researchers are speculating:

• Nature: It's possible that people with rheumatoid arthritis are born with a specific genetic defect that makes them prone to developing this condition.
• Nurture: We're all exposed to a variety of environmental hazards in our lives. And researchers speculate that exposure to certain viruses or bacteria may kick off an abnormally active immune system and increase susceptibility to RA.
• Other Possible Causes: Imbalances in the body can also be a cause for RA. Defects in the immune system, or chemical or hormonal imbalances, may cause the immune cells to fail to properly recognize the body's tissues as its own.
  We don't know for sure whether it's one of these factors - or some combination of them - that is behind RA, but researchers continue to try and find the answers.

Remember, a risk factor is just that: a factor. It's not the sole reason why someone will develop - or not develop - a condition. But it does shed light on a person's likelihood of developing that condition. Here are the things that can put you at increased risk for RA. If you suffer from more than one of them, you may want to talk with your doctor about what you can do to combat your increased risk.

•Weight: If you didn't have enough reasons to shed those extra pounds before, here's a new one. People who are obese are at increased risk of developing RA.
•Coffee: While there is no hard evidence of this link yet, some studies have suggested that there is a connection between drinking coffee and developing rheumatoid arthritis.
•Smoking: Long-term smokers may also be at increased risk for the development of rheumatoid arthritis.
•Blood Transfusions: The risk of developing RA is also increased if you have received blood transfusions.
Unlike an infection - where the doctors can run a test, identify the bacteria, and prescribe the right antibiotic - rheumatoid arthritis is difficult to diagnose and treat.

In fact, there is no definitive way to determine if someone has RA. Instead, RA is generally diagnosed through a combination of symptoms and test results that indicate the presence of an autoimmune disorder.

Symptoms

The American College of Rheumatology defines rheumatoid arthritis as the presence of four of the seven symptoms listed below for more than 6 consecutive weeks:

•Morning stiffness that lasts over an hour
•Arthritis in at least three joints
•Arthritis of the joints of the hand
•Arthritis on both sides of the body (for example, involving both hands or both feet)
•A positive blood test for rheumatoid factor (RF)
•Presence of lumps under the skin, called rheumatoid nodules
•X-rays that show signs of rheumatoid arthritis affecting the joints
Testing

If you have six or seven of those symptoms, your doctor will probably diagnose you with RA without any further testing needed. But if there's a question about your condition - say, you have four or five of those symptoms - he may want to do further testing to confirm the diagnosis.

• Blood Tests: One simple blood test can give you a slew of information. Your doctor may look for symptoms of an autoimmune disorder by testing your blood's rheumatoid factor, anti citrullinated peptide antibody (anti cpp), erythrocyte sedimentation rate, antinuclear antibody, or c-reactive proteins.
• Imaging Tests: We've all had these types of tests before. They're MRIs, CT scans or x-rays. In the case of RA testing, they allow doctors to visualize the internal organs in order to see whether they've been damaged by the immune system.
• Arthrocentesis: This involves removing some joint fluid and testing it for the presence of white blood cells, crystals, or bacteria in the fluid. Instead of being used to find signs of RA, it's generally used to exclude other causes of the arthritis.
  Rheumatoid arthritis doesn't affect only one part of your body. In fact, RA sufferers generally have pain in three or more muscles and joints at any given time.

The most commonly affected joints are the extremities - wrists and fingers; knees, ankles, and feet. Most of the time, the discomfort will be symmetrical (the left and right wrists; the left and right ankles). But within these specific joints, the symptoms can include:

• Increased pain and stiffness in the morning (it lasts more than 30 minutes)
• Pain and stiffness after sitting still for an extended period of time
• Redness and swelling
• Mis-shapings and deformities
  Since RA is an autoimmune condition, and the immune system affects the entire body, the symptoms of RA also extend beyond those joints. Other ways that RA manifests itself is through:
• Fatigue: Intense tiredness, decreased energy, muscle aches, and even anemia
• Changes in eating habits: Decreased appetite and resulting weight loss
• Inflammation and bleeding: Inflamed blood vessels, stomach ulcers, or inflammation of the heart muscle and heart sac
• Neurological changes: Depression and difficulty sleeping
• Organ damage: Lung problems and vision problems
• Skin changes: Bumps occurring under the skin (rheumatoid nodules), rashes, sores or excessive sweating