Rheumatoid Arthritis is an autoimmune, chronic, progressive, systemic disease that predominantly involves the joints. It typically causes increased temperature, swelling and pain in the joints. It also affects other organs in the body, and, as a result, can cause low red blood cell count, lung inflammation and heart inflammation. It is one of the most common inflammatory rheumatic diseases worldwide. It is more common in women aged 20-50 years.

The aetiology of rheumatoid arthritis (RA) is complex and multifactorial. In individuals genetically predisposed to the development of RA and autoimmunity, the immune system is triggered by exposure to smoking, bacteria, viruses and other environmental components. Many cells, especially Macrophages, B Lymphocytes, T Lymphocytes and Neutrophils, play a role in the development of RA. The autoimmune system is activated years before the clinical manifestation of the disease. Autoantibodies develop against collagen in joints and some other systemic antigens. T Lymphocytes are also one of the main cells of RA. In RA, most of the cells found in the joint space are CD4+ T Lymphocytes. They trigger autoimmunity by recognizing their own body antigens as foreign. Cytokines such as TNF, IL-1 and IL-6 released from T lymphocytes activate other immune system cells and initiate inflammation. RA patients have too many B cells in their joint fluid. B cells in the joint fluid can group together to form lymphoid tissues. RF accumulates in the synovial fluid as immunocomplexes and causes damage.  RF can also be positive in many other diseases other than RA. Although it is positive in the vast majority of RA patients, the fact that it is negative does not rule out the disease. Anti-CCP is an autoantibody against citrulline found in the synovium. It is positive in up to 90% of RA patients (more sensitive and specific than RF). Contributes to inflammation by activating the complement system. It has also been shown that RA has a more severe course in Anti-CCP+ patients and can be used prognostically. IL-6 is the most abundant cytokine in the blood and joint fluid of RA patients. A strong correlation between IL-6 levels and disease activity has been shown.

Rheumatoid Arthritis (RA) is an autoimmune, chronic, progressive, systemic disease that causes joint pain and damage throughout the body. The pain caused by rheumatoid arthritis is usually felt on both sides of the body. Therefore, if there is any pain in the arms and legs, the other part will feel the same pain. It also affects other organs in the body, and, as a result, can cause low red blood cell count, lung inflammation and heart inflammation. It is one of the most common inflammatory rheumatic diseases worldwide. It is more common in women aged 20-50 years.

Fever, sweating, weakness, weight loss are the first symptoms. Joint findings are polyarticular, symmetrical and deforming. There is pain, morning stiffness, swelling, increased temperature and loss of function in the joints. There are no rashes. The finger joints, wrists, elbows, knees, shoulders and hips are most commonly affected. In the late period hand may show Boutonniere Deformity, Ulnar Deviation and Swann Neck Deformity. Small pieces called rheumatoid nodules can form under the skin near the affected joint. These pieces can be the size of a pea or a walnut. Other manifestations include vasculitis, pericarditis, Sjögren’s syndrome, uveitis, anaemia and amyloidosis.

Rheumatoid arthritis is a chronic disease that causes inflammation and pain in the joints. These symptoms often occur during the period of exacerbation of rheumatoid arthritis. Other rheumatoid arthritis symptoms:

• Fatigue
• Morning stiffness
• Joint pain
• Swelling in the joint
• Fever

The feeling of fatigue may occur before other symptoms appear and may increase day by day.

Morning stiffness is one of the earliest symptoms of rheumatoid arthritis. The stiffness may last several minutes or hours.

Joint stiffness is often accompanied by pain. These pains affect both parts of the body equally. The pain is usually in the fingers and wrists. It can also occur in the knees, feet, ankles and shoulders.

Inflammation in the joints can cause swelling. These swellings often occur during the period of exacerbation of rheumatoid arthritis.

If joint pain and inflammation are accompanied by fever, you may need to see your doctor. Fever is an early symptom of rheumatoid arthritis.

In the laboratory; Chronic Disease Anaemia, increased ESR, increased Acute Phase Reactants (CRP), RF Positivity (70%), Anti-CCP Antibody (80-90%) are in favour of Rheumatoid Arthritis. In the early stages of radiology; soft tissue swelling, osteoporosis around joint and joint narrowing may be observed. In the late period, general osteoporosis, deformities and ankylosis may be observed. There is no single test for diagnosing RA. The diagnosis is made by ruling out other possible causes in the presence of joint inflammation. In the differential diagnosis, Connective Tissue Diseases (SLE, SSc, PM/DM, Vasculitis, MKDH), Seronegative Spondyloarthropathies, Crystal Depository Diseases (Gout), Chronic Fatigue Syndrome, Fibromyalgia, Glucocorticoid Withdrawal Syndrome, Infectious Arthritis (viral), Intermittent arthritis, Osteoarthrosis should be ruled out.

The aim of rheumatoid arthritis treatment is to reduce pain, suppress inflammation, slow or stop joint damage, and improve well-being and function. Non-Steroidal Anti-Inflammatories, glucocorticoids, synthetic and biological DMARDs can be used in treatment.

The disease can be effectively treated with rheumatoid arthritis medications. Treatment of rheumatoid arthritis is usually with drugs that slow down the disease and prevent joint deformity.

A rheumatoid arthritis diet does not cure the disease, but with the right food choices, inflammatory problems that damage the body can be controlled and the patient can maintain a healthier weight. Excess weight can make rheumatoid arthritis medications less effective and the patient may experience increased joint pain due to weight.

Oily fish: Salmon, tuna, sardines, herring and other cold-water fish contain omega-3 fatty acids that can help control inflammation. 

Fruits and vegetables: Fruits and vegetables are full of antioxidants that help stabilise molecules called free radicals, which trigger inflammation and damage cells. They also contain vitamins and minerals that the body needs.

Whole grain foods: Oats, whole wheat, brown rice, quinoa and other whole grain foods can lower CRP levels and reduce the risk of heart disease in people with rheumatoid arthritis.  In addition, all of these products are rich in fiber.

Peas and beans: People with rheumatoid arthritis are prone to muscle loss. Peas and beans are an excellent source of protein for muscle health.

Olive oil: Use olive oil instead of other oils and fats.

Exacerbations of rheumatoid arthritis can be caused by inflammation. Cortisone medications can relieve joints that are painful and swollen and often flare up.