Other sophisticated surgical techniques on the horizon may ensure a healthier and less painful future for RA sufferers who already have permanent deformities.
Reducing the risk factors for heart disease
Many studies have shown that the risk of coronary artery disease is much higher in patients with RA. This is most likely because the chronic inflammation caused by RA speeds up the progression of atherosclerosis, the main cause of heart attack and stroke. Those with RA are also more likely to be smokers and to have high blood pressure, metabolic syndrome, obesity, and abnormal lipid levels than the general population. Most rheumatologists recommend that their RA patients exercise, watch their weight, eat a nutritious diet, keep their cholesterol and blood pressure under control, and stop smoking as part of their routine care. Check out Preventing & Reversing Heart Disease For Dummies (Wiley) to find out more.
Predicting the outcome
Predicting how a person with RA will fare is difficult; after all everyone is different. But certain factors can suggest that the course of the disease may be either easier or more difficult. For example, RA may be less severe if one or more of the following factors applies to you:
You’re female. Women are more likely to get RA; however the disease often takes a greater toll on men.
You have a college degree or better. Educated people tend to seek help earlier, are more likely to follow doctor’s orders to the letter, often have less physically strenuous jobs, and have better access to care.
You’re middle-aged or older when stricken.
You are diagnosed and treated as soon as possible. Studies confirm a “window of opportunity” in RA whereby people who are treated sooner and get the disease under control faster do better in the long run.
Your cartilage and bone ends have not been worn away, and you don’t yet have joint deformities.
You don’t have rheumatoid nodules.
Your level of rheumatoid factor is low and/or your anti-CCP test is negative. Remember, however, that some people who have little or no rheumatoid factor still suffer severely.
You don’t smoke. Smoking has been linked to more aggressive destruction of the joints.
You’re pregnant. Some women enjoy a nine-month period of time with fewer symptoms.
Focusing on the future
Today, rheumatoid arthritis rarely manifests as the crippling, deforming disease of just a few years ago. Researchers in genetics and immunology are constantly uncovering new and fascinating parts of this puzzle, and many new, highly effective drugs have been introduced to treat RA over the past 20 years. Great strides have also been made in surgical techniques, enabling surgeons to offer hope to those with deformed, painful joints. Through our rapidly expanding arsenal of knowledge, our medications, certain lifestyle changes, and new surgical techniques, we should soon be able to tame, if not conquer, the beast known as rheumatoid arthritis.
Understanding the Difference between Osteoarthritis and Rheumatoid Arthritis
RA and OA have two things in common: namely joint pain and damage to certain joint structures, such as the cartilage and the bone. Other than that, they’re about as different as night and day. Table 3-1 outlines the differences between RA and osteoarthritis.
TABLE 3-1 Rheumatoid Arthritis Compared to Osteoarthritis
| Rheumatoid Arthritis | Osteoarthritis |
|---|---|
| Joint inflammation and swelling are prominent symptoms. | Joint inflammation and swelling are less common. |
| Usually begins between the ages of 25 to 50, but can also strike children. | Usually begins after the age of 40. Rarely strikes children. |
| Settles in a majority of joints, especially fingers, wrists, shoulders, knees, and elbows. | Affects the weight-bearing joints primarily (for example, knees, hips, and spine). |
| Affects joints symmetrically (for example, both wrists). | Affects isolated joints or one joint at a time. |
| Morning stiffness lasts more than 30 minutes. | Brief periods of morning stiffness. |
| Often causes systemic symptoms, such as fatigue, fever, weight loss, and general malaise. In severe cases, they can attack organs outside the joints. | Does not cause systemic symptoms. |
Chapter 4
Investigating Other Forms of Arthritis
IN THIS CHAPTER
The various forms of arthritis all have one thing in common: They produce pain, swelling, and other problems in or near one or more joints. The symptoms may appear suddenly and obviously, or they may sneak up so gradually that you can’t remember when they began. They may strike with the force of a jackhammer or feel more like a chilly breeze. Sometimes the diagnosis is obvious; other times it may elude doctors for a year or longer. The varied treatments can be quick and effective, produce delayed reactions or in some cases, not work at all.
Osteoarthritis and rheumatoid arthritis, the subjects of Chapters 2 and 3, are well-known forms of arthritis. This chapter examines some of the lesser-known and less prevalent, but still troublesome, forms of the disease, including pseudogout, juvenile idiopathic arthritis, infectious arthritis, gonococcal arthritis (a form of infectious arthritis), psoriatic arthritis, and ankylosing spondylitis.
