Rheumatoid Arthritis

Rheumatoid Arthritis is a disease of the immune system which mainly affects joints. This disease is common and affects around 1% of the Australian population. The most commonly affected joints are the small joints of the hands and feet, but most joints of the upper and lower limbs can be affected. Symptoms include pain, swelling and stiffness, especially in the early morning.

The diagnosis is based on the history and examination. There are special blood tests that can be performed to aid the diagnosis but it should be noted that in up to 30% of patients with rheumatoid arthritis, these blood tests will not be detected. High levels of these specific blood tests, when found, potentially predict more aggressive and severe disease. Rheumatoid arthritis occurs more commonly within some families.

This is an important disease to diagnose and treat at an early stage. Rheumatoid arthritis can lead to severe deformity and destruction of joints, causing pain and loss of ability to perform daily tasks. Importantly, very effective medical therapy now exists to prevent these long term effects. In the last 10 years, many advances have been made, with new therapies developed and an improved understanding of how to use available medications.

Rheumatologists have also been better trained to anticipate possible side effects of medication and to use measures to avoid these side effects.

The most important realisation has been that there is a short window of opportunity to effectively switch off the disease. Rheumatoid arthritis, especially if the disease is aggressive, needs to be treated aggressively, often with combinations of medication, within the first 6 months of the onset of joint symptoms. Once the disease is in remission, there is then the opportunity to reduce and in some people, even cease medication use.

There is rapid advancement in the understanding and treatment of rheumatoid arthritis. The hope, and the increasing reality is that for newly diagnosed patients, the progression of the disease can be halted, and that long term damage of joints will be the exception, rather than the rule.