Rheumatoid arthritis and osteoarthritis both cause inflammation in the joints. But the former, if not diagnosed correctly and managed early, can become debilitating and crippling.
What is rheumatoid arthritis?
Rheumatoid arthritis (RA) is an autoimmune disorder where the body’s immune system attacks joints and their surrounding tissues, causing inflammation, pain, stiffness and swelling. As the disease progresses, the symptoms will worsen, leading to deformity and a loss of function and mobility.
As it is a systemic disorder, RA can affect other organs in the body like the eye, skin, heart and lungs.
Risk factors
RA can be triggered by a disorder of the body’s immune system or an overreaction to a virus infection. Once the immune system is mobilised, it starts to target the body’s own cells.
In RA, the target is the synovial membrane that covers the joints, which then becomes tender and swollen as fluid builds up in the joint cavity. The exact cause of the trigger is unclear, but some factors can increase the risk of developing the disease:
- Family history of RA
- Smoking, hormonal changes during pregnancy
- Anyone, even children, can get RA
- Women, who are three times more likely than men to get RA
Osteoarthritis
RA can be mistaken for osteoarthritis (OA), as they both cause inflammation. However, OA is due to wear and tear of the joints as people age. The symptoms, long-term effects and treatments for the two conditions are also very different. Hence, it is important that symptoms be assessed by rheumatology specialists to receive a correct diagnosis.
Early symptoms
- Pain, swelling in finger and wrist joints that last for hours
- Joint stiffness, especially in the mornings
- Joints on both sides of the body are affected
Advanced symptoms
- Joints are warm, tender and painful throughout the day
- Body stiffness
- Low-grade fever, fatigue, weight loss and poor appetite
- Deformity in the advanced stage as bone and cartilage are destroyed
Diagnosis
-Blood tests to detect the rheumatoid factor (RF) and anti-CCP (cyclic citrullinated peptide) antibodies
- Analysis of fluids in swollen joints, especially the knees
- Ultrasound scans if other tests are inconclusive
- X-rays, detailed medical history, physical examination for signs of joint inflammation
Treatment
RA has no cure and treatment is given to ease symptoms,
prevent further joint destruction, complications from developing and to regain lost muscle strength and
mobility.
- Medications to slow, stop RA advance
- Follow a balanced diet
- Exercise moderately, regularly
- Stop smoking and lose weight
- Surgery for deformed, destroyed joints
ARC for one-stop care
Treatments at specialised and dedicated RA clinics like Singapore General Hospital’s Autoimmunity and Rheumatology Centre (ARC) can have better outcomes.
The ARC offers specialised physical and occupational therapy services, drug management and patient education, on-site and virtual monitoring by specialist advanced practice nurses and pharmacists.
Under its musculoskeletal system ultrasound service (MSUS), the ARC’s rheumatologists use the advanced imaging tool to monitor and guide treatment, such as in titrating medication levels.
