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UT Southwestern Medical Center’s Rheumatology Program is among the nation’s leading clinical and research centers for rheumatoid arthritis and other rheumatic diseases. Our ongoing advances in developing diagnostic tests and therapies for this chronic condition help to provide patients with the most up-to-date treatments.
Expert Care for Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a chronic autoimmune disease in which the immune system attacks the bones and joints. The exact cause of RA is unknown, but researchers believe that heredity might contribute to the onset of the disease.
RA is one of the most damaging forms of arthritis and most commonly affects the hands, wrists, feet, ankles, knees, shoulders, and elbow joints. Inflammation is typically symmetric, so the same joints are affected on both sides of the body.
RA affects adults of all ages and races, with women three times more likely than men to develop the condition. The disease usually arises in middle age but can start as young as age 16.
Juvenile inflammatory arthritis, or JIA, occurs in children 16 or younger. Unlike adult rheumatoid arthritis, which is chronic and lasts a lifetime, children often outgrow JIA.
UT Southwestern’s skilled rheumatologists work closely with their multidisciplinary colleagues to deliver comprehensive care to people with RA, collectively striving to:
- Relieve symptoms and improve overall well-being
- Prevent joint and organ damage
- Improve physical function
- Reduce long-term complications
Symptoms of Rheumatoid Arthritis
RA symptoms can develop gradually or come on suddenly. Common symptoms include:
- Pain, warmth, and swelling of joints
- Early morning stiffness
- Enlarged or deformed joints
- Hard nodules (bumps) under the skin, near the affected joints
- Low-grade fever and flu-like symptoms
Less common symptoms include:
- Cysts behind the knees that can rupture, causing lower-leg swelling and pain
- Inflamed blood vessels (vasculitis)
- Inflamed membranes around the lungs (pleurisy) or the sac around the heart (pericarditis), or inflammation and scarring of the lungs, which can cause chest pain, difficulty breathing, and abnormal heart function
- Dry eyes and mouth
- Eye inflammation
Patients with RA have an increased risk of osteoporosis (bone thinning).
Diagnosing Rheumatoid Arthritis
It can be difficult for doctors to diagnose RA in its early stages because symptoms can be very subtle and go undetected on X-rays or in blood tests.
In addition to taking a thorough medical history and performing a comprehensive physical examination, doctors might order diagnostic tests such as X-rays and blood tests to detect certain antibodies, such as a rheumatoid factor or an anti-cyclic citrullinated peptide (anti-CCP). Providers might also check inflammatory markers.
People with four or more of these signs and symptoms may be diagnosed with RA:
- Morning stiffness that lasts longer than one hour for at least six weeks
- Three or more joints that are inflamed for at least six weeks
- Presence of arthritis in the hand, wrist, or finger joints for at least six weeks
- Blood tests that reveal rheumatoid factor or anti-CCP
- X-rays that show characteristic changes in the joints
Treating Rheumatoid Arthritis
UT Southwestern offers patients the best and latest in comprehensive care through all stages of treatment. We use a team approach when patients have other organ involvement (such as eyes and lungs).
The earlier an RA diagnosis is made and treatment is started, the more joint damage and impairment can be prevented.
RA medical treatments include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen
- Corticosteroids to reduce inflammation
- Disease-modifying medications to slow disease progression
- Immunosuppressive medications to quiet activity
- Biologic drugs that target specific steps in the inflammatory process
Other ways to manage the condition include:
- Assistive devices such as canes, crutches, or walkers
- Physical therapy to keep the joints from "freezing" and becoming immobile
- Heat or cold application to the joints
- Joint-replacement surgery
Specific RA treatment depends upon:
- Patient age, overall health, and medical history
- Severity and extent of the condition
- Expectation for the course of the condition
- Patient preferences and tolerance for medications, procedures, and therapies
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