ANNOUNCER: More than two million people have been diagnosed with rheumatoid arthritis in the United States.
STEVEN ABRAMSON, MD: It's one of the autoimmune diseases, which means the body attacks its own tissues. In this case, the tissues are the tissues that surround the joints, and initially it can cause swelling and stiffness. But with time, this inflammation actually damages the joints and can cause deformities of the joints and disability.
ANNOUNCER: While rheumatoid arthritis affects people of all ages and races, it is more common in women.
ERIC RUDERMAN, MD: Probably about three quarters women to one quarter men, although that varies in different age groups. It is a disease of younger patients. So the time that people get rheumatoid arthritis is typically in their 30s and 40s, which is much earlier than most people think of arthritis beginning. Children can actually get rheumatoid arthritis, as well as older people, so it can start at any age. But the most important thing to recognize is that it starts in 30s and 40s.
ANNOUNCER: There can also be a genetic basis to the disease.
CLIFTON O. BINGHAM, MD: What we understand now is that patients with rheumatoid arthritis have some underlying genetic susceptibilities to the disease itself. We see the disease cluster in families and run in families. It certainly doesn't mean that it's 100% inherited, but genetics probably account for about 30% -- 20 to 30% of the disease itself.
ANNOUNCER: Symptoms may vary from person to person. The symptoms typically develop gradually and are often marked by periods of flares and remissions.
ALISA KOCK, MD: Signs and symptoms include initially swelling of the joints, particularly the small joints of the hands and the feet.
ERIC RUDERMAN, MD: You see swelling, you see redness. Sometimes they'll feel sort of squishy, the joints, as if there's fluid in them. Typically people will have pain in those joints. They'll feel like they don't move very well. They'll be stiff, particularly in the mornings. Stiffness in the mornings is a very common presentation or common symptom. It tends to be symmetrical, so that if a certain joint on one side of the body is involved, it'll usually be involved on the other side of the body, although that's not 100%, and it's not always the exact same joints on one side as the other.
ANNOUNCER: Unlike osteoarthritis, which affects only your bones and joints, rheumatoid arthritis can affect the whole body.
ERIC RUDERMAN, MD: You can get lung involvement, with fluid around the lungs. You can get fluid around the heart. You can get nodules, which is inflammation or swelling along tendons in different places. People feel very fatigued, typically, because of the inflammation. They feel sick. Their whole body is involved, and the fatigue and the difficulty getting around is often a bigger symptom for people than the pain in the individual joints.
ANNOUNCER: Diagnosing rheumatoid arthritis is complex and takes many factors into consideration.
CLIFTON O. BINGHAM, MD: Rheumatoid arthritis is a condition that we diagnose based on a number of clinical symptoms and some laboratory markers. Oftentimes, a patient may present with one or two joints that are bothering him. And it's only after a period of time that the pattern begins to look like the disease we call RA.
ERIC RUDERMAN, MD: X-rays can be helpful. You can see changes on X-rays, but if the symptoms are very early, if things have just started, the X-rays may be normal, and you may not see anything yet.
ANNOUNCER: Blood tests may help doctors make the diagnosis.
CLIFTON O. BINGHAM, MD: We look for elevations of what we call acute phase reactants and these are the erythrocyte sedimentation rate, which we often call the sed rate or ESR. Or the C-reactive protein or CRP. These are both elevated in many patients of rheumatoid arthritis. These are blood tests that reflect inflammation, not just in the joint, but in the body as a whole.
ANNOUNCER: A patient's blood may also be checked for antibodies often associated with rheumatoid arthritis.
ALISA KOCH, MD: These tests may include rheumatoid factor, which is an antibody. And it's present in about 80 to 85% of patients. Over the last few years, there has been a second antibody that has come to the fore, which is also a good diagnostic marker for rheumatoid arthritis, and this antibody is called anti-citrullinated peptide, anti-CCP is how it's commonly referred to. And it seems that anti-CCP is as good at picking up rheumatoid arthritis as rheumatoid factor. So it's very important to have both the symptoms and signs, clinical symptoms and signs, as well as laboratory confirmation.
STEVEN ABRAMSON, MD: It's very important that a person gets a diagnosis or an evaluation by a rheumatologist, because we have to be able to make that diagnosis even when the blood tests are negative so that we make the proper treatment decisions early, even in that first year of the disease.
ANNOUNCER: In spite of rheumatoid arthritis' impact on patients' lives, new treatment options are offering patients more control over their symptoms and a better quality of life.
Hi , I've had RA for 40 yrs now,I am 42yrs old and all my joints in my body are effected, have been on prednisone 5mg and celebrex, and panadeine forte for 15 yrs , have experimented with diet, and yes it says alot, the more alkaline the better, ridding my diet of wheat, sugar, and limit perservatives in foods has helped tremendously, moving joints that have been stiff for years, I have just started on the Cinnamon & honey tea, twice a day, and have high hopes on what I have researched on this combination, I will update you on my progress, in a few weeks, Karen from North Brisbane