Rheumatoid Arthritis
Causes, Symptoms, Diagnosis, and Effective Treatment
Rheumatoid arthritis is the most common inflammatory joint disease. Without proper treatment, it leads to progressive joint damage, deformity, and loss of mobility. Modern medical approaches allow doctors to slow disease progression significantly and improve patients’ quality of life.
What Is Rheumatoid Arthritis?
Rheumatoid arthritis (RA), also known as chronic polyarthritis, is a chronic autoimmune inflammatory disease that primarily affects the joints but may also involve internal organs. The disease is characterized by symmetrical joint inflammation, causing pain, swelling, stiffness, and limited mobility.
Approximately 1% of adults worldwide suffer from rheumatoid arthritis. Women are affected more frequently than men. The disease can develop at any age, but most commonly begins between 50 and 70 years. In children, this condition is referred to as juvenile idiopathic arthritis.
Causes of Rheumatoid Arthritis
The exact causes of rheumatoid arthritis are not fully understood. Current research suggests a combination of genetic predisposition and environmental factors, such as smoking or certain infections.
These factors may trigger an abnormal immune response, leading to chronic inflammation of the joints. Understanding these mechanisms helps explain how arthritis can be cured or controlled, especially when diagnosed early.
How Does Rheumatoid Arthritis Develop?
The pathogenesis of rheumatoid arthritis involves a dysfunctional immune system that mistakenly attacks the body’s own tissues. This autoimmune process leads to chronic inflammation of the synovial membrane, progressive cartilage destruction, and bone erosion.
Inflammatory mediators such as tumor necrosis factor alpha (TNF-α) and interleukins play a key role in joint damage. These insights form the basis of modern arthritis procedures and targeted therapies.
How Do Doctors Determine Arthritis?
Diagnosis is based on internationally accepted criteria developed by the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR).
This answers a common patient question: how do doctors determine arthritis and how does arthritis get diagnosed?
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ACR/EULAR Classification Criteria
Diagnosis is based on a point system evaluating four areas:
- joint involvement;
- blood test results;
- acute-phase inflammatory markers;
- duration of symptoms.
A total score of 6 points or more (out of 10) confirms the diagnosis of rheumatoid arthritis.
Symptoms and Stages of Rheumatoid Arthritis
Rheumatoid arthritis progresses through several stages:
Stage 1
- mild morning stiffness;
- slight swelling of small joints (hands, wrists, feet);
- fatigue and general discomfort.
Stage 2
- persistent synovitis;
- increasing pain and reduced joint mobility.
Stage 3
- severe pain and inflammation;
- joint deformities and loss of function;
- muscle atrophy and rheumatoid nodules.
Stage 4
- irreversible joint damage;
- pain even at rest;
- joint fusion and complete loss of mobility;
- significant decline in quality of life.
Diagnostic Tests for Rheumatoid Arthritis
To understand how arthritis gets diagnosed, doctors use:
- clinical examination;
- blood tests (RF, anti-CCP antibodies);
- imaging studies: ultrasound, X-ray, MRI, bone scintigraphy.
Early diagnosis is essential when considering how to treat early onset arthritis effectively.
How Rheumatoid Arthritis Is Treated in Germany
The main goal of treatment is to control inflammation, reduce pain, and preserve joint function.
Non-Drug Treatment Options
- physiotherapy and occupational therapy;
- surgical interventions in advanced cases.
Drug Therapy – What Do I Take for Arthritis?
- glucocorticoids;
- non-steroidal anti-inflammatory drugs (NSAIDs);
- disease-modifying antirheumatic drugs (DMARDs).
Conventional DMARDs:
- methotrexate;
- leflunomide;
- sulfasalazine.
Targeted Synthetic DMARDs (JAK inhibitors):
- upadacitinib;
- filgotinib;
Biological Therapies:
- TNF inhibitors (adalimumab, etanercept, infliximab);
- Tocilizumab, Rituximab, Abatacept
These approaches represent effective treatment for arthritis and are widely used in leading German rheumatology centers.
Muscular Arthritis Treatment and Surgical Options
In advanced stages, muscular arthritis treatment may include corrective orthopedic surgery, joint replacement, or reconstructive procedures to restore mobility and reduce pain.
Monitoring and Prognosis
Rheumatoid arthritis requires continuous medical monitoring. Without treatment, the disease leads to severe disability and reduced life expectancy.
Thanks to modern therapies, early and targeted treatment can dramatically improve outcomes. Many patients now live with minimal symptoms and maintain an active lifestyle—demonstrating how arthritis can be cured or controlled, even if not completely eliminated.
Prevention of Rheumatoid Arthritis
There is no specific prevention strategy. However, a healthy lifestyle, smoking cessation, and early medical consultation at the first symptoms significantly reduce disease severity.
References:
(1) Albrecht K. et al. (2023). Systematic review on the prevalence of inflammatory rheumatic diseases in Germany. Rheumatology Journal, 2023. DOI: 10.1007/s00393-022-01305-2.
(2) Aletaha D. et al. (2010). 2010 Rheumatoid Arthritis Classification Criteria. Arthritis & Rheumatism. DOI: 10.1002/art.27584.
(3) Josef S. et al. (2020; updated 2022). EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying anti-rheumatic drugs. Annals of the Rheumatic Diseases. DOI: 10.1136/annrheumdis-2019-216655.
(4) AWMF. S3 Guideline for the Treatment of Early Rheumatoid Arthritis.
