RHEUMATOID ARTHRITIS

The exact cause of rheumatoid arthritis remains unknown, but several factors contribute to its onset:

• Immune System Dysfunction: Rheumatoid arthritis is an autoimmune disorder in which the immune system attacks healthy joint tissues, causing inflammation.
• Genetic Predisposition: Individuals with a family history of rheumatoid arthritis have a higher risk of developing the condition.
• Environmental Triggers: Smoking, infections, and exposure to pollutants may increase risk.
• Hormonal Influence: Rheumatoid arthritis is more common in women, suggesting hormonal factors play a role.

Rheumatoid arthritis symptoms typically develop gradually and worsen over time. Common signs include:

Joint-Related Symptoms:

• Persistent Pain & Swelling: Most commonly affects small joints (hands, wrists, feet) in a symmetrical pattern.
• Morning Stiffness: Lasting over an hour, unlike osteoarthritis, where stiffness improves quickly.
• Reduced Joint Function: Difficulty in performing daily tasks due to pain and stiffness.

Systemic Symptoms:

• Fatigue & Weakness: Chronic inflammation can lead to extreme tiredness.
• Fever & Weight Loss: Some individuals experience low-grade fever and unintended weight loss.
• Eye, Heart, & Lung Involvement: In severe cases, inflammation can extend beyond the joints, affecting vital organs.

Early and accurate diagnosis is essential to prevent joint damage and systemic complications. At Harley Street Medical Centre, we use a combination of:

• Clinical Examination: Assessing joint tenderness, swelling, and range of motion.
• Blood Tests: Identifying inflammatory markers like rheumatoid factor (RF) and anti-CCP antibodies.
• Imaging Tests: X-rays, ultrasound, or MRI scans help detect early joint erosion and inflammation.
• Disease activity measures: This is combined international standard scores that measure how active the disease is and are used over time to confirm response and improvement.

At Harley Street Medical Centre, we offer a multidisciplinary approach to arthritis care, focusing on pain relief, joint preservation, and improved mobility. Our treatments include:

• Medications – NSAIDs for pain relief, corticosteroids for inflammation, and DMARDs or biologics to null the symptoms and slow disease progression. These are given with the guidance of the rheumatologist and can be in the form of pills, injectables or infusions. Biologics have revolutionized the treatment of Rheumatoid arthritis by improving the quality of life and controlling the disease to a quiescent stage aka remission state. This led to preservation of the joint function and reduced the need for joint replacements when used early in the disease.
• Physical Therapy – Targeted exercises to maintain joint flexibility, improve muscle strength, and reduce stiffness.
• Orthotic Support – For conditions affecting the feet and lower limbs, orthotics can help offload pressure from deformed joints, improve alignment, and reduce discomfort. Custom braces, splints, and shoe inserts can provide additional support and stability.
• Surgical Intervention – In cases when treatment is delayed and disease does not respond to treatment, surgical options may be considered to restore function and relieve pain. These include:
  • Joint Replacement Surgery (Arthroplasty): Affected joints, such as knees or hips, are replaced with artificial implants.
  • Synovectomy: Removal of the inflamed synovial lining to reduce pain and swelling.
  • Joint Fusion (Arthrodesis): Fusing bones to increase joint stability in severely damaged areas.