How rheumatoid arthritis presents
Rheumatoid arthritis is a systemic autoimmune disease in which the immune system attacks the synovial lining of joints, causing chronic inflammation. It typically affects the small joints of the hands and feet in a symmetric pattern, though any joint can be involved. Morning stiffness lasting more than 30 minutes, joint swelling, and fatigue are common early features. Beyond joints, RA can affect the lungs, heart, eyes and blood vessels, making comprehensive assessment essential.
Early diagnosis and treatment with disease-modifying antirheumatic drugs (DMARDs) significantly improve long-term outcomes and reduce the risk of irreversible joint damage. Delayed treatment allows progressive erosive joint damage that may not be fully reversible.
- Symmetric joint pain and swelling — hands, feet, wrists
- Morning stiffness lasting more than 30 minutes
- Fatigue, weight loss, low-grade fever
- Systemic features — lung, heart, eye involvement in some patients
- Erosive joint damage if treatment is delayed
Related: Rheumatology → · Dr. Jitendra Knowledge Hub → · ICHD-3 Topic →
Treatment approach
Treatment follows a treat-to-target strategy aiming for remission or low disease activity. Conventional DMARDs such as methotrexate are first-line, often combined with short-term corticosteroids during flares. Biologic DMARDs (TNF inhibitors, IL-6 inhibitors, rituximab) or targeted synthetic DMARDs (JAK inhibitors) are used when conventional therapy is insufficient. Regular monitoring of disease activity, inflammatory markers and drug safety blood tests ensures optimal management.
Physical and occupational therapy support joint function and quality of life. Patient education covers medication adherence, recognition of flares, joint protection strategies and lifestyle modifications.
- Methotrexate — first-line conventional DMARD
- Corticosteroids — short-term bridge during flares
- Biologic DMARDs — TNF inhibitors, IL-6 inhibitors, rituximab
- JAK inhibitors — targeted synthetic DMARDs
- Regular monitoring — disease activity, inflammatory markers, drug safety