Definition
:Rheumatoid
arthritis (RA) is a chronic systemic inflammatory disease of unknown
cause. The hallmark feature of this condition is persistent symmetric
polyarthritis (synovitis) that affects the hands and feet, although
any joint lined by a synovial membrane may be involved.
Extra-articular involvement of organs such as the skin, heart, lungs,
and eyes can be significant.
Etiology
:
The
cause of RA is unknown. Genetic, environmental, hormonal,
immunologic, and infectious factors may play significant roles.
Socioeconomic, psychologic, and lifestyle factors may influence
disease outcome.
Epidemiology
:
- The annual incidence is approximately 3 cases per 10,000 population.
- The prevalence rate is approximately 1%, increasing with age and peaking at age 35-50 years.
- Women are affected by RA approximately 3 times more often than men.
- The pathogenesis of RA is not completely understood.
- An external trigger (eg, infection, trauma) that triggers an autoimmune reaction
- leading to synovial hypertrophy and chronic joint inflammation along with the potential for extra-articular manifestations.
- Is theorized to occur in genetically susceptible individuals.
- Synovial cell hyperplasia and endothelial cell activation are early events in the pathologic process
- Genetic factors and immune system abnormalities contribute to disease propagation.
- Abnormal production of numerous cytokines, chemokines, and other inflammatory mediators has been Demonstrated in patients with RA.
- Inflammation and exuberant proliferation of synovium leads to destruction of various tissues, including cartilage, bone, tendons, ligaments, and blood vessels.By Dr Shall
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