Most experts believe that rheumatoid arthritis (RA) occurs as a result of some type of stress on the body that triggers an autoimmune response characterized by chronic inflammation, swelling, and pain in joint spaces as cartilage erodes and bony cysts cause deformities in the joints and joint motion is lost. Certain genes associated with the immune system have been found to increase the possibility of developing RA.
Initially, persons with RA may have general, vague complaints such as fatigue, weakness, weight loss, anorexia, low-grade fever, and tingling in the hands and feet during the weeks or months after some traumatic physical event in their life. Joint stiffness lessens as the day progresses but may recur after inactivity and is worse after strenuous activity. Although all joints may be affected, the proximal interphalangeal or metacarpophalangeal joints and joints of the wrists, knees, ankles, and toes are most often affected. Rheumatoid nodules may be found on the hands and elbows. Sjogren?s syndrome may also be present. There is also potential for renal, cardiovascular, pulmonary, neurological, and ophthalmological involvement. RA is a disease of remissions and exacerbations and therefore should be monitored regularly.
- Sharon W. Stark, R.N., A.P.R.N., D.N.Sc.