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Specialists
in Diseases Afflicting the Joints
Rheumatoid Arthritis (RA)

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Original article printed on page 32 in the March 20, 2013 issue of
The Mississauga News under the feature: Health & Beauty, Medicine Matters.
Portrait of Dr. Peter W. Kujtan, supplied 2005
Dr. Peter W. Kujtan

The spectrum of rheumatologic illness for many patients can present as a hidden disability. Most of us cannot appreciate the limitations which must be observed while enduring pain.

Rheumatologists are doctors who specialize in treating diseases afflicting the joints mostly. Osteoarthritis which essentially is a wearing down of the joint cartilage is the commonest, and rheumatoid arthritis is second most common, but a lot more disabling. We consider it to be a systemic illness, because it has effects in areas beyond the joints. It afflicts about 1 in a 100 people, and strikes women more often, particularly smokers.

There is pain in many joints at once, and on both sides of the body. For example, fingers, wrists, elbows and ankles can all hurt at once. The joints get swollen and stiff particularly in the morning. Extra-articular symptoms refer to symptoms outside the joints such as weight loss, fatigue, fever and vague muscle aches.

It is not till some time later that we start to see deformities of the fingers and swollen joints, as the cartilage gets destroyed. These people sometimes get mistakenly branded as malingerers when they develope frozen shoulders, difficulty using their hands or walking. What is often forgotten is that rheumatoid arthritis can cause enlargement of the spleen, inflammation of the lungs, heart, eyes and other tissues.

The diagnosis can be a difficult one to make, and takes careful team work and observation to make. Bloodwork is not always positive, but when we see an elevated rheumatoid factor, it becomes more confirmative. Radiographs or x-rays are part of the standard work up, and can be revealing. Attempts are made to involve the skills of rheumatologists early on, since monitoring disease progression is essential.

The initial work-up consists of a good history and examination. Blood tests and x-rays usually follow. Medication and an exercise program come next, with joint replacement surgery being considered in the most severe cases.

Maintaining a good diet helps since cartilage is 70% water. Ensure that your Calcium and Vitamin D intake is adequate. Glucosamine- Chondroitin is not a herb but rather a non-prescription drug combination of a steroid and basic amino acid that is non-regulated, and can help. Please ensure that your physician is aware of all substances that you ingest and use regularly.


Related resources:

Rheumatoid Arthritis Pictures Slideshow from MedicineNet. Reviewed by William C. Shiel Jr., MD, FACP, FACR.

Rheumatoid Arthritis: Test Your Arthritis IQ from MedicineNet.

Rheumatoid Arthritis: Causes, Incidence, and Risk Factors from National Center for Biotechnology Information, U.S. National Library of Medicine. "Rheumatoid arthritis (RA) is a long-term disease that leads to inflammation of the joints and surrounding tissues. It can also affect other organs. The cause of RA is unknown. It is an autoimmune disease, which means the body's immune system mistakenly attacks healthy tissue. RA can occur at any age, but is more common in middle age. Women get RA more often than men. Infection, genes, and hormone changes may be linked to the disease."

Rheumatoid arthritis from Wikipedia. "Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks flexible (synovial) joints. It can be a disabling and painful condition, which can lead to substantial loss of functioning and mobility if not adequately treated."

Handout on Health: Rheumatoid Arthritis from National Institutes of Health. How Does Rheumatoid Arthritis Affect People’s Lives? What Causes Rheumatoid Arthritis? How Is Rheumatoid Arthritis Diagnosed? How Is Rheumatoid Arthritis Treated? Who Treats Rheumatoid Arthritis? What You Can Do: The Importance of Self-Care. What Research Is Being Done on Rheumatoid Arthritis?

Rheumatoid Arthritis from Mayo Clinic. " Rheumatoid arthritis is a chronic inflammatory disorder that typically affects the small joints in your hands and feet. Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.

An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues. In addition to causing joint problems, rheumatoid arthritis can also affect your whole body with fevers and fatigue."

Rheumatoid Arthritis (RA) Pictures Slideshow: Joint-Friendly Exercises & Fitness Routines from MedicineNet. Reviewed by Andrew Seibert, MD.

Rheumatoid Arthritis from NHS.uk. Introduction to Rheumatoid arthritis, Symptoms, Causes, Diagnosis, Treatment, Complications, Living with Rheumatoid arthritis.

A Better Life for People with Rheumatoid Arthritis from National Rheumatoid Arthritis Society (NRAS), UK. Info for patients.

Rheumatoid Arthritis: Part One. YouTube video, 28:41 min. Rheumatoid arthritis affects 1.3 million Americans. Research advances and drug development have helped control this chronic disease. Noted UCLA Rheumatology expert Dr. Michael Weisman, presents an update on the latest treatments in the first of two lectures. Series: The Coming of Age Lecture Series.

Rheumatoid Arthritis: Part Two. YouTube video, 28.41 min. Dr. Michael Weisman, presents an update on the latest treatments in the second of two lectures.

Rheumatoid Arthritis from eMedicine Medscape. Author: Katherine K Temprano, MD; Chief Editor: Herbert S Diamond, MD. Medical info for professionals.

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