Rheumatoid Arthritis

Paul Wordsworth, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
Wendy Holden, Nuffield Orthopaedic Centre, Oxford, UK

Published online: January 2006

DOI: 10.1038/npg.els.0004113

Rheumatoid arthritis is a common inflammatory disorder primarily affecting synovial joints but also other organs. It is characterized by immune-driven chronic inflammation, relapses and remissions. It is strongly associated with the presence of rheumatoid factor in the blood and has a significant genetic predisposition, notably from certain immune response genes. Dramatic advances in therapies mean that progressive disability may no longer be inevitable.

Keywords: aetiology; immunogenetics; treatment; epidemiology; management

Figure 1. Cumulative involvement of joints in rheumatoid arthritis.
Figure 2. Typical rheumatoid joint deformities in the hands. There is wasting of the small muscles of the hand, swelling of the metacarpophalangeal joints and a small subcutaneous nodule on the little finger. The fingernail ‘clubbing’ is characteristic of the pulmonary fibrosis from which this patient also suffered.
Figure 3. Plain radiograph (left) and magnetic resonance image (right) of the cervical spine in rheumatoid arthritis, revealing subaxial subluxation and spinal cord compression.
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 Further Reading
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    Maini R, St Clair EW and Breedveld F et al. for the ATTRACT Study Group (1999) Infliximab (chimeric anti-tumour necrosis factor monoclonal antibody) versus placebo in rheumatoid arthritis patients receiving concomitant methotrexate: a randomised phase III trial. Lancet 354: 1932–1939.
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    Weinblatt ME, Keystone EC, Furst DE et al. (2003) Adalimumab, a fully human anti-tumor necrosis factor alpha monoclonal antibody, for the treatment of rheumatoid arthritis in patients taking concomitant methotrexate: the ARMADA trial. Arthritis and Rheumatism 48: 35–45.
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    book Wordsworth BP, Bell JI (1998) "Specific immune responses". In: Isenberg DA, Maddison PJ, Isenberg D et al. (eds) The Oxford Textbook of Rheumatology, 3rd edn, pp. 424–432. Oxford: Oxford University Press
    Wordsworth BP, Lanchbury JSS, Sakkas LI et al. (1989) HLA-DR4 subtype frequency in RA indicates that DRB1 is the major susceptibility locus within the human leukocyte antigen class II region. Proceedings of the National Academy of Sciences of the USA 86: 10049–10053.

Related Sub-Topics:

Autoimmunity | Inflammation | Health Care
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Article Title: Rheumatoid Arthritis
 
How to Cite close
Wordsworth, Paul, and Holden, Wendy(Jan 2006) Rheumatoid Arthritis. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1038/npg.els.0004113]