2

Angela D. Hawkes Greensboro Medical Associates PA 1511 Westover Ter Ste 201 Greensboro, NC 27408 (336) 373-1537

3

Anthony S. Anderson Greensboro Medical Associates PA 1511 Westover Ter Ste 201 Greensboro, NC 27408 (336) 373-1537

4

William W. Truslow William W Truslow MD 409 Parkway Ste A Greensboro, NC 27401 (336) 379-7597

5

James F. Beekman Greensboro Medical Associates PA 1511 Westover Ter Ste 201 Greensboro, NC 27408 (336) 373-1537

6

Michelle Young Greensboro Medical Associates 1511 Westover Ter Ste 201 Greensboro, NC 27408 (336) 373-0611

7

Erin J. Gray Regional Physicians Jamestown 5710 High Point Rd Ste I Greensboro, NC 27407 (336) 299-7000

8

Erin J. Gray Greensboro Medical Associates PA 1511 Westover Ter Ste 201 Greensboro, NC 27408 (336) 373-1537

9

Shaili B. Deveshwar Piedmont Orthopedics 1313 Carolina St Ste 101 Greensboro, NC 27401 (336) 275-0927

10

Tauseef G. Syed Novant Health Franklin Family Medicine 445 Pineview Dr Ste 200 Kernersville, NC 27284 (336) 564-4410

11

Aldona Ziolkowska Medical Arts Clinic 1814 Westchester Dr Ste 301 High Point, NC 27262 (336) 802-2025

12

George W. Kernodle Kernodle Clinic West 1234 Huffman Mill Rd Burlington, NC 27215 (336) 538-1234

13

Brett Smith Wake Forest Baptist Health Rheumatology 301 Medical Center Blvd Winston-Salem, NC 27157 (336) 716-4209

14

Amer Alkhoudari Wake Forest Baptist Health Rheumatology 301 Medical Center Blvd Winston-Salem, NC 27157 (336) 716-4209

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Nilamadhab Mishra Wake Forest Baptist Health Rheumatology 301 Medical Center Blvd Winston-Salem, NC 27157 (336) 716-4209

16

Nihad Yasmin Wake Forest Baptist Health Rheumatology 301 Medical Center Blvd Winston-Salem, NC 27157 (336) 716-4209

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Sadiq Ali Wake Forest Baptist Health Rheumatology 301 Medical Center Blvd Winston-Salem, NC 27157 (336) 716-4209

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Julio R. Bravo Novant Health Franklin Family Medicine 1995 Bethabara Rd Winston-Salem, NC 27106 (336) 896-1477

19

Nkechinyere Emejuaiwe Wake Forest Baptist Health Rheumatology 301 Medical Center Blvd Winston-Salem, NC 27157 (336) 716-4209

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Dennis Ang Wake Forest Baptist Health Rheumatology 301 Medical Center Blvd Winston-Salem, NC 27157 (336) 716-4209

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Kenneth S. O'Rourke Wake Forest Baptist Health Rheumatology 301 Medical Center Blvd Winston-Salem, NC 27157 (336) 716-4209

22

Erin K. Shiner Novant Health Franklin Family Medicine 1995 Bethabara Rd Winston-Salem, NC 27106 (336) 896-1477

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Douglas L. Metcalf Novant Health Franklin Family Medicine 1900 S Hawthorne Rd Ste 652 Winston-Salem, NC 27103 (336) 277-0361

24

Elliott L. Semble Salem Rheumatology 180 Kimel Park Dr Ste 250 Winston-Salem, NC 27103 (336) 659-4585

25

Nicole W. Klett Triangle Orthopedic Associates 120 William Penn Plz Durham, NC 27704 (919) 220-5306

26

George B. Brothers Chapel Hill Internal Medicine 940 Martin Luther King Jr Blvd Chapel Hill, NC 27514 (919) 942-5123

27

Anne K. Toohey Triangle Orthopedic Associates PA 120 William Penn Plz Durham, NC 27704 (919) 220-5306

28

Joanne M. Jordan UNC Rheumatology Allergy Immunology Clinic 101 Manning Dr Chapel Hill, NC 27514 (919) 966-4131

29

Rakesh C. Patel Rowan Diagnostic Clinic 611 Mocksville Ave Salisbury, NC 28144 (704) 633-7220

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Stacy D. Kennedy Rowan Diagnostic Clinic 611 Mocksville Ave Salisbury, NC 28144 (704) 633-7220

31

Durga D. Adhikari University Of North Carolina Rheumatology Clinic 6013 Farrington Rd Ste 301 Chapel Hill, NC 27517 (919) 966-4191

32

Jennifer L. Rogers UNC Rheumatology Allergy & Immunology Clinic 6013 Farrington Rd Ste 301 Chapel Hill, NC 27517 (919) 962-4824

33

Jennifer L. Rogers University Of North Carolina Rheumatology Clinic 6013 Farrington Rd Ste 301 Chapel Hill, NC 27517 (919) 966-4191

Original post:
Greensboro NC Rheumatologist Doctors - Rheumatoid Arthritis ...

2

Richard S. Glick Richard S Glick MD 6405 N Federal Hwy Ste 105 Fort Lauderdale, FL 33308 (954) 772-3660

3

Trumane J. Ropos Ropos Rheumatology 6405 N Federal Hwy Ste 103 Fort Lauderdale, FL 33308 (954) 358-1325

4

Aviva C. Hopkins Holy Cross Physician Partners 1000 NE 56th St Fort Lauderdale, FL 33334 (954) 351-7800

5

Jihan M. Saba Holy Cross Physician Partners 1000 NE 56th St Fort Lauderdale, FL 33334 (954) 351-7800

6

Richard K. Mastrole Holy Cross Physician Partners 1900 E Commercial Blvd Ste 101 Fort Lauderdale, FL 33308 (954) 351-5838

7

Christine N. Savage University Of Miami Medical Gro 1475 NW 12th Ave Fl 1 Miami, FL 33136 (305) 243-7545

8

Amarie Negron-Rodriguez Cria Center For Rheumatology & Immunology 2900 W Cypress Creek Rd Ste 11 Fort Lauderdale, FL 33309 (954) 229-7030

9

Yvonne R. Smallwood-Sherrer Cria Center For Rheumatology & Immunology 2900 W Cypress Creek Rd Ste 11 Fort Lauderdale, FL 33309 (954) 229-7030

10

Elliot S. Cohen Elliot S Cohen MD Inc 1801 W Hillsboro Blvd Deerfield Beach, FL 33442 (954) 429-9050

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Elias Halpert West Broward Rheumatlgy Asscs 7431 N University Dr Ste 300 Tamarac, FL 33321 (954) 724-5560

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Kevin E. Stone West Broward Rheumatlgy Asscs 7431 N University Dr Ste 300 Tamarac, FL 33321 (954) 724-5560

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Steven C. Kimmel West Broward Rheumatlgy Asscs 7431 N University Dr Ste 300 Tamarac, FL 33321 (954) 724-5560

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Alan R. Alberts West Broward Rheumatlgy Asscs 7431 N University Dr Ste 300 Tamarac, FL 33321 (954) 724-5560

15

Barry K. Waters Florida Institute Of Health 3100 Coral Hills Dr Ste 302 Coral Springs, FL 33065 (954) 341-5034

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Shawn B. Baca Rheumatology Associates South Florida 5162 Linton Blvd Ste 101 Delray Beach, FL 33484 (561) 498-1114

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Korey R. Ullrich Rheumatology Associates South Florida 5162 Linton Blvd Ste 101 Delray Beach, FL 33484 (561) 498-1114

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Joseph Z. Forstot Rheumatology Associates South Florida 1050 NW 15th St Ste 212A Boca Raton, FL 33486 (561) 368-5611

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Arnold S. Falchook Arnold S Falchook MD 1050 NW 15th St Ste 106A Boca Raton, FL 33486 (561) 362-1166

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Margaret R. Wilkes Rheumatology Associates South Florida 5162 Linton Blvd Ste 101 Delray Beach, FL 33484 (561) 498-1114

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Ira Pardo Rheumatology Associates South Florida 5162 Linton Blvd Ste 101 Delray Beach, FL 33484 (561) 498-1114

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David Alboukrek Rheumatology Associates South Florida 5162 Linton Blvd Ste 101 Delray Beach, FL 33484 (561) 498-1114

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Lori F. Soberal Rheumatology Associates South Florida 5162 Linton Blvd Ste 101 Delray Beach, FL 33484 (561) 498-1114

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William A. Sunshine William A Sunshine MD 660 Glades Rd Ste 306 Boca Raton, FL 33431 (561) 862-0401

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Steven L. Feldman Florida Institute Of Health 7351 W Oakland Park Blvd Ste 104 Lauderhill, FL 33319 (954) 741-5800

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David Makover David Makover MD 2900 N Military Trl Ste 244 Boca Raton, FL 33431 (561) 367-0078

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Prabodh K. Kapila Prabodh K Kapila MD 201 NW 82nd Ave Ste 303 Plantation, FL 33324 (954) 370-1153

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Julia Savloff Integral Rheumatology & Immunology Specialists 140 SW 84th Ave Ste B Plantation, FL 33324 (954) 476-2338

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Lilliam Ayala Garcia Integral Rheumatology & Immunology Specialists 140 SW 84th Ave Ste B Plantation, FL 33324 (954) 476-2338

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Guillermo J. Valenzuela Integral Rheumatology & Immunology Specialists 140 SW 84th Ave Ste B Plantation, FL 33324 (954) 476-2338

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Steven I. Goodman Arthritis Associates South 5130 Linton Blvd Ste F1 Delray Beach, FL 33484 (561) 483-1100

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Michael G. Indelicato Arthritis Associates South 5130 Linton Blvd Ste F1 Delray Beach, FL 33484 (561) 483-1100

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Marypat L. Clements Arthritis Associates South 5130 Linton Blvd Ste F1 Delray Beach, FL 33484 (561) 483-1100

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Philippe A. Saxe Arthritis Associates South 5130 Linton Blvd Ste F1 Delray Beach, FL 33484 (561) 483-1100

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Phillip S. Kallen Arthritis Associates South 5130 Linton Blvd Ste F1 Delray Beach, FL 33484 (561) 483-1100

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Brett R. Hutton Advanced Rheumatology Center 15300 Jog Rd Ste 101 Delray Beach, FL 33446 (561) 819-3100

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Evan J. Abramsky Advanced Rheumatology Center 15300 Jog Rd Ste 101 Delray Beach, FL 33446 (561) 819-3100

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Marc J. Hirsh Advanced Rheumatology Center 15300 Jog Rd Ste 101 Delray Beach, FL 33446 (561) 819-3100

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Alain Alvarez Advanced Rheumatology Center 15300 Jog Rd Ste 101 Delray Beach, FL 33446 (561) 819-3100

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Hope Starkman Ocean Ridge Arthritis Associates 1880 N Congress Ave Ste 320 Boynton Beach, FL 33426 (561) 736-9699

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Yesenia D. Santiago Kahn & Raskin MDs 1 SW 129th Ave Ste 401 FL 4 Pembroke Pines, FL 33027 (954) 450-8980

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Lynette M. Weitman Nicholson Kahn & Raskin MDs 1 SW 129th Ave Ste 401 FL 4 Pembroke Pines, FL 33027 (954) 450-8980

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Wayne G. Riskin Kahn & Raskin MDs 1 SW 129th Ave Ste 401 FL 4 Pembroke Pines, FL 33027 (954) 450-8980

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Michelle J. Parlo Kahn & Raskin MDs 1 SW 129th Ave Ste 401 FL 4 Pembroke Pines, FL 33027 (954)
450-8980

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Charles B. Kahn Kahn & Raskin MDs 1 SW 129th Ave Ste 401 FL 4 Pembroke Pines, FL 33027 (954) 450-8980

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Eileen J. Ginsburg Boynton Beach Arthritis Center 13550 Jog Rd Ste 204 Delray Beach, FL 33446 (561) 737-1947

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Rosa T. Artola Benjamin L Lechner MD 2100 E Hallandale Beach Blvd Ste 302 Hallandale Beach, FL 33009 (954) 456-8900

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Eva M. Cappiello Boynton Beach Arthritis Center 13550 Jog Rd Ste 204 Delray Beach, FL 33446 (561) 737-1947

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Richard A. Cappiello Boynton Beach Arthritis Center 13550 Jog Rd Ste 204 Delray Beach, FL 33446 (561) 737-1947

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Benjamin L. Lechner Benjamin L Lechner MD 2100 E Hallandale Beach Blvd Ste 302 Hallandale Beach, FL 33009 (954) 456-8900

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Paul Sweeney Chain Medical 2150 W 68th St Ste 200 Hialeah, FL 33016 (305) 828-4300

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Rheumatoid Arthritis Center - Pompano Beach, FL

Arthritis is a broad term that covers a group of over 100 diseases. It has everything to do with your joints -- the places where your bones connect -- such as your wrists, knees, hips, or fingers. But some types of arthritis can also affect other connective tissues and organs, including your skin.

About 1 out of 5 adults have some form of the condition. It can happen to anyone, but it becomes more common as you age.

With many forms of arthritis, the cause is unknown. But some things can raise your chances of getting it.

Arthritis mainly causes pain around your joints. You might also have:

The symptoms can be constant, or they may come and go. They can range from mild to severe.

More-severe cases may lead to permanent joint damage.

Osteoarthritis and rheumatoid arthritis are the most common kinds.

In osteoarthritis,the cushions on the ends of your bones, called cartilage, wear away. That makes the bones rub against each other. You might feel pain in your fingers, knees, or hips.

It usually happens as you age. But if underlying causes are to blame, it can begin much sooner. For example, an athletic injury like a torn anterior cruciate ligament (ACL) or a fracture near a joint can lead to arthritis.

Continued here:
Arthritis - types of arthritis - WebMD

Arthritis (from Greek arthro-, joint + -itis, inflammation; plural: arthritides) is a form of joint disorder that involves inflammation of one or more joints.[1][2] There are over 100 different forms of arthritis.[3][4] The most common form of arthritis is osteoarthritis (degenerative joint disease), a result of trauma to the joint, infection of the joint, or age. Other arthritis forms are rheumatoid arthritis, psoriatic arthritis, and related autoimmune diseases. Septic arthritis is caused by joint infection.

The major complaint by individuals who have arthritis is joint pain. Pain is often a constant and may be localized to the joint affected. The pain from arthritis is due to inflammation that occurs around the joint, damage to the joint from disease, daily wear and tear of joint, muscle strains caused by forceful movements against stiff painful joints and fatigue.

There are several diseases where joint pain is primary, and is considered the main feature. Generally when a person has "arthritis" it means that they have one of these diseases, which include:

Joint pain can also be a symptom of other diseases. In this case, the arthritis is considered to be secondary to the main disease; these include:

An undifferentiated arthritis is an arthritis that does not fit into well-known clinical disease categories, possibly being an early stage of a definite rheumatic disease.[5]

Pain, which can vary in severity, is a common symptom in virtually all types of arthritis. Other symptoms include swelling, joint stiffness and aching around the joint(s). Arthritic disorders like lupus and rheumatoid arthritis can affect other organs in the body, leading to a variety of symptoms.[7] Symptoms may include:

It is common in advanced arthritis for significant secondary changes to occur. For example, arthritic symptoms might make it difficult for a person to move around and/or exercise, which can lead to secondary effects, such as:

These changes, in addition to the primary symptoms, can have a huge impact on quality of life.

Arthritis is the most common cause of disability in the USA. More than 20 million individuals with arthritis have severe limitations in function on a daily basis.[8]Absenteeism and frequent visits to the physician are common in individuals who have arthritis. Arthritis can make it very difficult for individuals to be physically active and some become home bound.

It is estimated that the total cost of arthritis cases is close to $100 billion of which almost 50% is from lost earnings. Each year, arthritis results in nearly 1 million hospitalizations and close to 45 million outpatient visits to health care centers.[9]

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Arthritis - Wikipedia, the free encyclopedia

Arthritis Arthritis Overview

Arthritis is a joint disorder featuring inflammation. A joint is an area of the body where two bones meet. A joint functions to allow movement of the body parts it connects. Arthritis literally means inflammation of one or more joints. Arthritis is frequently accompanied by joint pain. Joint pain is referred to as arthralgia.

Arthritis is classified as one of the rheumatic diseases. These are conditions that are different individual illnesses, with differing features, treatments, complications, and prognosis. They are similar in that they have a tendency to affect the joints, muscles, ligaments, cartilage, and tendons, and many have the potential to affect internal body areas as well.

There are many forms of arthritis (over 100 have been described so far, and the number is growing). The forms range from those related to wear and tear of cartilage (such as osteoarthritis) to those associated with inflammation as a result of an overactive immune system (such as rheumatoid arthritis). Together, the many forms of arthritis make up the most common chronic illness in the United States.

Arthritis sufferers include men and women, children and adults. More than half of those with arthritis are under 65 years of age. A majority of Americans with arthritis are women.

Medically Reviewed by a Doctor on 9/8/2015

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Arthritis: Get the Facts About Symptoms and Diet

What Is Arthritis?

Arthritis is inflammation of the joints (the points where bones meet) in one or more areas of the body. There are more than 100 different types of arthritis, all of which have different causes and treatment methods. The symptoms of arthritis usually appear gradually but they may also occur suddenly. Arthritis is most commonly seen in adults over the age of 65 but it can also develop in children and teens. According to the Centers for Disease Control and Prevention, arthritis is more common in women than men and in those that are overweight (CDC).

Cartilage is a flexible, connective tissue in joints that absorbs the pressure and shock created from movement like running and walking. It also protects the joints and allows for smooth movement.

Some forms of arthritis are caused by a reduction in the normal amount of this cartilage tissue. Osteoarthritis, one of the most common forms of arthritis, is caused by normal wear and tear throughout life; this natural breakdown of cartilage tissue can be exacerbated by an infection or injury to the joints.

The risk of developing osteoarthritis may be higher if you have a family history of the disease.

Another common form of arthritis, rheumatoid arthritis, occurs when your bodys immune system attacks the tissues of the body. These attacks affect the synovium, which secretes a fluid that nourishes the cartilage and lubricates the joints. Rheumatoid arthritis can eventually lead to the destruction of both bone and cartilage inside the joint. The exact cause of the immune systems attacks has not yet been discovered, but scientists have discovered genetic markers that increase your risk of developing rheumatoid arthritis tenfold.

The most common symptoms of arthritis involve the joints. Joint pain and stiffness, mostly in the morning, are typical signs, along with swelling of the joints. You may also experience a decrease in range of motion of your joints or redness of the skin around the joint.

In the case of rheumatoid arthritis you may feel tired or experience a loss of appetite because of the inflammation caused by your bodys attacking immune system. You may also become anemic (experience decreased red blood cells) or have a slight fever. Severe rheumatoid arthritis can cause joint deformity if left untreated.

Diagnosis of arthritis will start with your physician performing a physical exam, during which he or she will check for limited range of motion in the joint, the feeling of fluid around joints, or warm or red joints. Extraction and analysis of your bodily fluids like blood and joint fluid can help your doctor determine what kind of arthritis you have by checking for inflammation levels. Imaging scans such as X-ray, MRI, and CT scans are commonly used to produce an image of your bones and cartilage so your doctor can better determine whether something like a bone spur is the cause of your symptoms.

The main goal of treatment is to reduce the amount of pain youre experiencing and prevent any additional damage to the joints. Improving your joint function is also important, and you may be prescribed a combination of treatment methods to achieve the best results.

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Arthritis: Causes, Signs & Diagnosis - Healthline

Rheumatology Associates of Houston

Welcome and thank you for visiting the Rheumatology Associates of Houston website. Our dedicated physicians, professional and friendly manager and staff make it possible for us to provide the best care and environment for comprehensive treatment of your arthritis.

Arthritis can be a painful, oftentimes debilitating disease, which can greatly impact your quality of life. This condition currently affects over 2.5 million people in the United States roughly 1% of the population. Recent developments in research have helped provide earlier and more accurate diagnosis and effective treatment options. It is now possible to return to a normal life again, with minimal discomfort.

Rheumatology Associates of Houston remains dedicated to using the latest and most effective diagnostic and treatment options for our patients. Each of our physicians has been in practice for more than 10 years. They play an important role in monitoring and assessing the activity of your rheumatoid arthritis. Therefore, it is valuable to develop a doctor/patient partnership by keeping your appointments and utilizing our on-site services offered for your convenience and safety.

If you are experiencing pain and swelling in your joints, it is time to find help. We are experienced and dedicated to treating those suffering from arthritis or related illnesses. Furthermore, we strive to educate our patients and their families on the symptoms, treatments, and complications of rheumatic diseases. Our specially trained, board-certified physicians will work with you to improve your quality of life.

Our physicians have helped alleviate the pain of many people throughout Houston. We specialize in the treatment of:

Within our website, you will find recent comprehensive information about rheumatoid arthritis and other autoimmune disorders, including different treatment methods and answers to common questions related to these diseases.

Please call our office at (713) 667-8292 to find out more about our services or to schedule an appointment. We offer flexibility in scheduling your appointments and we work with your insurance carriers to minimize your out of pocket expense. Our physicians will provide you with a comprehensive evaluation and will offer treatment options tailored to the individual patient.

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Houston Arthritis Treatment | Rheumatology Associates of Houston

Arthritis facts Arthritis is inflammation of one or more joints. Symptoms of arthritis include pain and limited function of joints. Arthritis sufferers include men and women, children and adults. A rheumatologist is a medical arthritis expert. Earlier and accurate diagnosis can help to prevent irreversible damage and disability. What is arthritis? What causes arthritis?

Arthritis is a joint disorder featuring inflammation. A joint is an area of the body where two different bones meet. A joint functions to move the body parts connected by its bones. Arthritis literally means inflammation of one or more joints.

Arthritis is frequently accompanied by joint pain. Joint pain is referred to as arthralgia.

There are many types of arthritis (over 100 identified, and the number is growing). The types of arthritis range from those related to wear and tear of cartilage (such as osteoarthritis) to those associated with inflammation resulting from an overactive immune system (such as rheumatoid arthritis). Together, the many types of arthritis make up the most common chronic illness in the United States.

The causes of arthritis depend on the form of arthritis. Causes include injury (leading to osteoarthritis), metabolic abnormalities (such as gout and pseudogout), hereditary factors, the direct and indirect effect of infections (bacterial and viral), and a misdirected immune system with autoimmunity (such as in rheumatoid arthritis and systemic lupus erythematosus).

Arthritis is classified as one of the rheumatic diseases. These are conditions that are different individual illnesses, with differing features, treatments, complications, and prognoses. They are similar in that they have a tendency to affect the joints, muscles, ligaments, cartilage, and tendons, and many have the potential to affect other internal body areas.

Medically Reviewed by a Doctor on 5/7/2015

Arthritis - Effective Treatments Question: What kinds of treatments have been effective for your arthritis?

Arthritis - Symptoms Question: What symptoms did you experience with arthritis?

Arthritis - Diet and Fish Oil Question: Do you follow a special diet for arthritis? Does it involve fish oils? Please discuss your diet.

Continued here:
Arthritis: Facts on Diet, Treatment and Symptoms

Note: There are different data sources for some of the arthritis-related statistics therefore; case definitions and terminology will also vary. Read more.

Nearly 1 in 2 people may develop symptomatic knee OA by age 85 years.

Two in three people who are obese may develop symptomatic knee OA in their lifetime.

1 in 4 people may develop painful hip arthritis in their lifetime.

Note: There are different data sources for some of the arthritis-related statistics therefore; case definitions and terminology will also vary. Read more.

An estimated 52.5 million adults in the United States reported being told by a doctor that they have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia.

One in five (22.7%) adults in the United States report having doctor diagnosed arthritis.

In 2010-2012, 49.7% of adults 65 years or older reported an arthritis diagnosis.

By 2030, an estimated 67 million Americans ages 18 years or older are projected to have doctor-diagnosed arthritis.

Arthritis & Rheumatism 2006;54(1):226-229 [Data Source: 2003 NHIS]

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CDC - Arthritis - Data and Statistics - Arthritis Related ...

Rheumatoid arthritis (RA) causes premature mortality, disability and compromised quality of life in the industrialized and developing world (1). Rheumatoid arthritis is a systemic inflammatory disease which manifests itself in multiple joints of the body. The inflammatory process primarily affects the lining of the joints (synovial membrane), but can also affect other organs. The inflamed synovium leads to erosions of the cartilage and bone and sometimes joint deformity. Pain, swelling, and redness are common joint manifestations. Although the causes are unknown, RA is believed to be the result of a faulty immune response. RA can begin at any age and is associated with fatigue and prolonged stiffness after rest. There is no cure for RA, but new effective drugs are increasingly available to treat the disease and prevent deformed joints. In addition to medications and surgery, good self-management, including exercise, are known to reduce pain and disability.

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The etiology, or cause, of RA is unknown. Many cases are believed to result from an interaction between genetic factors and environmental exposures.

Socio-demographics: The incidence of RA is typically two to three times higher in women than men. The onset of RA, in both women and men, is highest among those in their sixties(2)

Genetics: There is longstanding evidence that specific HLA class II genotypes are associated with increased risk. Most attention has been given to the DR4 and DRB1 molecules of the major histocompatability complex HLA class II genes. The strongest associations have been found between RA and the DRB1*0401 and DRB1*0404 alleles (12). More recent investigations indicate that of the more than 30 genes studied, the strongest candidate gene is PTPN22, a gene that has been linked to several autoimmune conditions(12).

Modifiable: Several modifiable risk factors have been studied in association with RA including reproductive hormonal exposures, tobacco use, dietary factors, and microbial exposures.

Smoking Among these risk factors, the strongest and most consistent evidence is for an association between smoking and RA. A history of smoking is associated with a modest to moderate (1.3 to 2.4 times) increased risk of RA onset (2). This relationship between smoking and RA is strongest among people who are ACPA-positive (anti-citrullinated protein/peptide antibodies), a marker of auto-immune activity (12).

Reproductive and breastfeeding history Hormones related to reproduction have been studied extensively as potential risk factors for RA:

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CDC - Arthritis - Basics - Definition - Rheumatoid Arthritis

Managing arthritis: Young people share their tips and advice
Young people share their advice on coping with arthritis. They discuss where to find information and help, and share their experiences of growing up with the condition. For information on...

By: Arthritis Research UK

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Managing arthritis: Young people share their tips and advice - Video

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder that primarily affects joints.[1] It may result in deformed and painful joints, which can lead to loss of function. The disease may also have signs and symptoms in organs other than joints.

The cause of rheumatoid arthritis is not completely understood. The process involves inflammation and fibrosis of the capsule around the joints. It also affects the underlying bone and cartilage.[1] RA can produce diffuse inflammation in the lungs, the membrane around the heart, the membranes of the lung, and whites of the eye. It can also produce nodular lesions, most common within the skin. It is a clinical diagnosis made mostly on the basis of symptoms and physical examination. X-rays, laboratory testing, and synovial fluid analysis might help support a diagnosis or exclude other diseases with similar symptoms.[2]

Treatments include both medication and non-pharmacological measures - the goal being to control joint inflammation and prevent joint damage and disability. Non-pharmacological treatment includes physical therapy, splints and braces, occupational therapy and dietary changes but these do not stop the progression of joint destruction. Painkillers and anti-inflammatory drugs, including steroids, suppress symptoms, but do not stop the progression either. Disease-modifying antirheumatic drugs (DMARDs) may slow or halt the progress of the disease.[2] Biological DMARDS like anti-TNF agents are effective but usually avoided in persons with active disease or hypersensitivity to these agents.[3] They have been shown to decrease the number of tender or swollen joints and the pain and disability due to the disease but there is little data about side effects.[4]Alternative medicine is not supported by evidence.[5][6][7]

RA affects between 0.5 and 1% of adults in the developed world with between 5 and 50 per 100,000 people newly developing the condition each year.[8] Onset is most frequent during middle age, but people of any age can be affected.[9] In 2013 it resulted in 38,000 deaths up from 28,000 deaths in 1990.[10] The name is based on the term "rheumatic fever", an illness which includes joint pain and is derived from the Greek word -rheuma (nom.), -rheumatos (gen.) ("flow, current"). The suffix -oid ("resembling") gives the translation as joint inflammation that resembles rheumatic fever. The first recognized description of RA was made in 1800 by Dr. Augustin Jacob Landr-Beauvais (17721840) of Paris.[11]

RA primarily affects joints, however it also affects other organs in more than 1525% of individuals.[12]

Arthritis of joints involves inflammation of the synovial membrane. Joints become swollen, tender and warm, and stiffness limits their movement. With time, multiple joints are affected (it is a polyarthritis). Most commonly involved are the small joints of the hands, feet and cervical spine, but larger joints like the shoulder and knee can also be involved.[13]:1089 Synovitis can lead to tethering of tissue with loss of movement and erosion of the joint surface causing deformity and loss of function.[2]

RA typically manifests with signs of inflammation, with the affected joints being swollen, warm, painful and stiff, particularly early in the morning on waking or following prolonged inactivity. Increased stiffness early in the morning is often a prominent feature of the disease and typically lasts for more than an hour. Gentle movements may relieve symptoms in early stages of the disease. These signs help distinguish rheumatoid from non-inflammatory problems of the joints, often referred to as osteoarthritis or "wear-and-tear" arthritis. In arthritis of non-inflammatory causes, signs of inflammation and early morning stiffness are less prominent with stiffness typically less than one hour, and movements induce pain caused by mechanical arthritis.[14] The pain associated with RA is induced at the site of inflammation and classified as nociceptive as opposed to neuropathic.[15] The joints are often affected in a fairly symmetrical fashion, although this is not specific, and the initial presentation may be asymmetrical.[13]:1089

As the pathology progresses the inflammatory activity leads to tendon tethering and erosion and destruction of the joint surface, which impairs range of movement and leads to deformity. The fingers may suffer from almost any deformity depending on which joints are most involved. Specific deformities, which also occur in osteoarthritis, include ulnar deviation, boutonniere deformity, swan neck deformity and "Z-thumb." "Z-thumb" or "Z-deformity" consists of hyperextension of the interphalangeal joint, fixed flexion and subluxation of the metacarpophalangeal joint and gives a "Z" appearance to the thumb.[13]:1089 The hammer toe deformity may be seen. In the worst case, joints are known as arthritis mutilans due to the mutilating nature of the deformities.[1]

The rheumatoid nodule, which is sometimes cutaneous, is the feature most characteristic of RA. It is a type of inflammatory reaction known to pathologists as a "necrotizing granuloma". The initial pathologic process in nodule formation is unknown but may be essentially the same as the synovitis, since similar structural features occur in both. The nodule has a central area of fibrinoid necrosis that may be fissured and which corresponds to the fibrin-rich necrotic material found in and around an affected synovial space. Surrounding the necrosis is a layer of palisading macrophages and fibroblasts, corresponding to the intimal layer in synovium and a cuff of connective tissue containing clusters of lymphocytes and plasma cells, corresponding to the subintimal zone in synovitis. The typical rheumatoid nodule may be a few millimetres to a few centimetres in diameter and is usually found over bony prominences, such as the elbow, the heel, the knuckles, or other areas that sustain repeated mechanical stress. Nodules are associated with a positive RF (rheumatoid factor) titer and severe erosive arthritis. Rarely, these can occur in internal organs or at diverse sites on the body.[citation needed].

Several forms of vasculitis occur in RA. A benign form occurs as microinfarcts around the nailfolds. More severe forms include livedo reticularis, which is a network (reticulum) of erythematous to purplish discoloration of the skin caused by the presence of an obliterative cutaneous capillaropathy.[citation needed].

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