What Is Rheumatoid Arthritis? Causes and Complications

Published: October 16, 2023

Author: Prof. Maria José Rego de Sousa, Ph.D.

What Is Rheumatoid Arthritis?

Rheumatoid arthritis is a chronic, inflammatory, autoimmune disease characterized by inflammation of the inner lining of the joints (symmetrical synovitis), affecting approximately 40,000 people in Portugal.

It is an autoimmune disease, meaning the immune system attacks the body’s healthy tissues instead of protecting them. Over the long term, it leads to joint erosion, resulting in chronic pain and loss of function.

This condition occurs more frequently in women than in men (3 to 1), typically between the ages of 35 and 50; however, it can affect anyone at any age. The first signs manifest as joint pain, followed by stiffness and difficulty moving.

With a deeper understanding of what rheumatoid arthritis is and the warning signs of this condition, the likelihood of an early diagnosis and the start of treatment increases, which, in turn, helps improve people’s quality of life and prevent serious complications in the future.

Causes and Risk Factors

Although the exact causes of this condition are not yet fully understood by the medical community, it is known that its onset results from an individual’s genetic predisposition, combined with risk factors such as smoking and obesity.

Some studies also point to a possible link with viral or bacterial infections, which trigger the body’s autoimmune response.

Possible Complications

Rheumatoid arthritis is a progressive disease, and if not treated correctly and promptly, it can lead to serious complications, such as:

• Carpal tunnel syndrome;
• Tendon rupture;
• Cervical myelopathy (in more advanced stages);
• Osteoporosis;
• Joint deformities;

In addition, in some cases, extra-articular manifestations may occur, such as myocarditis (heart inflammation), pleurisy (inflammation of the pleura), polyneuritis (inflammation of the nerves), and keratoconjunctivitis (inflammation of the conjunctiva and sclera).

Early Diagnosis

Early diagnosis of rheumatoid arthritis is of the utmost importance, allowing for prompt initiation of treatment, since structural damage occurs in the early years of the disease and there is an opportunity to minimize its long-term progression.

But what exactly is rheumatoid arthritis? Once a clinical suspicion has been raised, it is up to the clinical pathologist to clarify, through laboratory tests, the condition—which must be distinguished from other conditions with the same symptoms, such as gout and other forms of rheumatism, as well as viral or bacterial infections.

To this end, the following laboratory tests may be performed:

General Tests

• Complete blood count;
• Erythrocyte sedimentation rate and C-reactive protein;
• Urea/Creatinine;
• Uric acid;
• Liver function tests;
• Viral serology (HBV/HCV);
• Synovial fluid analysis;

Specific Tests

• Anti-CCP2 antibodies;
• Rheumatoid factor;
• Antinuclear Antibodies (ANA);

Treatment

Although there is no definitive cure for rheumatoid arthritis, its treatment involves a combination of medications and therapies, tailored according to the progression of the disease.

The main goals of treatment are:

• Reducing inflammation and relieving symptoms;
• Preventing disease progression and minimizing joint damage;
• Improving the patient’s quality of life and promoting functional independence.
• Among the most commonly used medications for treating rheumatoid arthritis are:
• Anti-inflammatory drugs (NSAIDs);
• Analgesics;
• Corticosteroids;
• Disease-modifying antirheumatic drugs (DMARDs).

In addition, it is recommended that patients follow a routine of low-impact physical exercises to maintain joint mobility and flexibility. Therapies such as physical therapy and occupational therapy can also be beneficial.

Living with Rheumatoid Arthritis

Living with rheumatoid arthritis can be a major challenge, especially when the condition is in a more advanced stage. However, this outcome is rare in most cases. When diagnosed early, patients are able to enjoy a life that is close to normal.

Advances in medicine and the emergence of new treatment options, as well as complementary diagnostic and therapeutic methods, enable healthcare professionals to recognize the early signs and refer patients for treatment.

Nevertheless, we recommend that you stay informed about rheumatoid arthritis, its symptoms, and warning signs so that you can identify changes in your condition and seek medical help when necessary.

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