RA, not OA

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Rheumatoid arthritis (RA) is an autoimmune disorder where the body’s immune system attacks joints and their surrounding tissues, causing inflammation, pain, stiffness and swelling. As the disease progresses, the symptoms will worsen, leading to deformity and a loss of function and mobility.

As it is a systemic disorder, RA can affect other organs in the body like the eye, skin, heart and lungs.

RA can be triggered by a disorder of the body’s immune system or an overreaction to a virus infection. Once the immune system is mobilised, it starts to target the body’s own cells.

In RA, the target is the synovial membrane that covers the joints, which then becomes tender and swollen as fluid builds up in the joint cavity. The exact cause of the trigger is unclear, but some factors can increase the risk of developing the disease:

RA can be mistaken for osteoarthritis (OA), as they both cause inflammation. However, OA is due to wear and tear of the joints as people age. The symptoms, long-term effects and treatments for the two conditions are also very different. Hence, it is important that symptoms be assessed by rheumatology specialists to receive a correct diagnosis.

Pain, swelling in finger and wrist joints that last for hours

Joint stiffness, especially in the mornings

Joints on both sides of the body are affected

Blood tests to detect the rheumatoid factor (RF) and anti-CCP (cyclic citrullinated peptide) antibodies

Analysis of fluids in swollen joints, especially the knees

Ultrasound scans if other tests are inconclusive

X-rays, detailed medical history, physical examination for signs of joint inflammation

Smoking, hormonal changes during pregnancy

Anyone, even children, can get RA

Joints are warm, tender and painful throughout the day Body stiffness

Low-grade fever, fatigue, weight loss and poor appetite

Deformity in the advanced stage as bone and cartilage are destroyed

Women, who are three times more likely than men to get RA

RA has no cure and treatment is given to ease symptoms, prevent further joint destruction, complications from developing and to regain lost muscle strength and mobility.

Follow a balanced diet

Exercise moderately, regularly Stop smoking and lose weight

Surgery for deformed, destroyed joints

Treatments at specialised and dedicated RA clinics like Singapore General Hospital’s Autoimmunity and Rheumatology Centre (ARC) can have better outcomes.

The ARC offers specialised physical and occupational therapy services, drug management and patient education, on-site and virtual monitoring by specialist advanced practice nurses and pharmacists. Under its musculoskeletal system ultrasound service (MSUS), the ARC’s rheumatologists use the advanced imaging tool to monitor and guide treatment, such as in titrating medication levels.