Rheumatoid arthritis

What is it?

Rheumatoid arthritis (RA) is a long-term, auto-immune disorder affecting the synovial joints (the ones that facilitate movement) of the body. It can also affect organs, causing cardiovascular disease, lung disease and osteoporosis.

Why does it occur?

The cause is an auto-immune disease, but certain factors can increase your risk of developing rheumatoid arthritis, such as a family history of auto-immune conditions, smoking, and being exposed to high levels of silica (silicon dioxide) in the workplace.

What are the symptoms?

Rheumatoid arthritis leads to inflammation of the synovial membrane (inside the bones), leading to swollen, tender and warm joints, which in turn can become stiff and painful. Symptoms are often worse in the morning and ease with physical activity. As the condition progresses, inflammation leads to the  destruction of the joint surface, the erosion of cartilage, and damage to surrounding soft tissues such as tendons. This can develop into rapidly progressing joint deformity and changes in the skin. Rheumatoid arthritis most commonly affects the small joints of the hands, but can also affect the spine and larger joints such as hips and knees.

How is it diagnosed?

Your consultant will carry out a medical examination, order imaging – including x-rays and MRI scans – and blood tests to look for rheumatoid factors and other antibodies characteristically found in rheumatoid arthritis.

How is it treated?

Non-surgical treatment

Lifestyle changes, such as regular exercise and weight loss, will be followed by medication in the form of disease modifying agents (DMARDS), such as methotrexate, hydroxychloroquine and TNF-alpha inhibitors. In the vast majority of cases, these medications dramatically improve symptoms and keep the condition under control for many years.

Surgical treatment

If your symptoms become particularly acute, surgery may be necessary. Joints in the fingers and hands may require a synovectomy (a procedure where the synovial tissue surrounding a joint is removed) to reduce pain, swelling and prevent tendon damage. In larger joints, such as the hips and knees, joint replacement surgery may be necessary.

One Orthopaedics team specialists

Mike Lemon

Consultant Orthopaedic Surgeon FRCS (Tr&Orth), Knee and Hip

Oliver Templeton-Ward

Consultant Orthopaedic Surgeon FRCS (Tr&Orth), Knee

Kerry Acton

Consultant Orthopaedic Surgeon FRCS (Tr&Orth), Hip and Knee

Julie Kohls

Consultant Orthopaedic Surgeon FRCS (Tr&Orth), Foot and Ankle

Daniela Tonucci

Pain Management Consultant FRCA FFPMRCA

Adam Way

Consultant Orthopaedic Surgeon FRCS (Tr&Orth), Spine