When a healthy immune system attacks a part of the body by mistake causing inflammation or painful swelling. The medical diagnosis for this is an autoimmune disorder. Rheumatoid Arthritis or "RA" mainly attacks joints such as the wrist, hands, and knees usually at once. This prolonged inflammation leads to pain, swelling, balance and unsteady gate in a person. Other tissue that are affected by rheumatoid arthritis are the lungs, heart, and eyes. There have been several links to rheumatoid arthritis such as obesity, periodontitis, and lung diseases. 

Let’s take a brief review of Immune system and inflammatory process file:///Users/ermuunbulgan/Downloads/4953853a891249d28a9c6f11347f0d74.html.

In the process off chronic and progressive disease of Rheumatoid Arthritis (RA), it can affect tissues and organs within the body, but most commonly synovial membranes of diarthrodial, or freely moving joints causing synovitis. These joints are bilateral and symmetrical, so the pain and swelling also can be expected in the same pattern bilaterally. RA tends to progress from top to bottom joints (Holman, 2019). The exact pathophysiology is unclear, but it is known that some unknown antigen is the trigger for immune system attack at these synovial points (Hoffman & Sullivan, 2020). That has been the case until recently. According to The Scientist researchers may have found the bacterial strain Subdoligranum that trigger development of Rheumatoid Arthritis. The evidence showed that given this bacteria, mice developed human RA like symptoms and individuals had increased inflammatory process and T-cell activation  in comparison with healthy control group. This research team is in no rush claiming this strain as the main trigger of RA as they haven’t eliminated other bacterial strains that could also cause RA (Thomasy, 2023).

During this trigger time, an inflammatory process begins and the immune system is unable to distinguish self from the non-self-tissue causing destruction to joints at synovial membrane. Once the inflammation begins, the synovial fluid increases and the membrane thickens due to scarring. Video process of RA.

So how is our immune system attacking itself? During these attacks, these unknown Antigens activate Monocytes & T-Lymphoctyes as well as B-Lymphocytes. B cells produce antibodies that bind with these antigens and form immune complexes. When phagocytosis of these immune complexes take place, inflammatory reactions happen: leukotrienes and prostaglandins are produced. Leukotrienes attract more white blood cells to the site and prostaglandin modifies the inflammation. From these two, collagenase is also produced and breaks down collagen causing synovial membrane proliferation and scarring (pannus), as well as bone erosion and cartilage destruction (Hoffman & Sullivan, 2020).· 

What increases my chances of developing rheumatoid arthritis?

What risk factors can I change to decrease my risk?

• Sore, swollen joints 

• Joints that are stiffest in the morning, along with inactivity

• Weight loss associated with fatigue and loss of appetite 

• Fever

• Aching/pain in more than one joint

• Joints that feel warm

knees, ankles, wrists, elbows, hips, and shoulders can all be affected

usually small joints are affected first

most often joints that are affected occur on both sides of the body.

• Medications prescribed by your physican may include 

  • corticosteroids like prednisone do delay joint damage and decrease inflammation. 

  • Recommended NSAIDs such as ibuprofen or naproxen. 

  • Conventional DMARDs hydroxychloroquine to slow disease progression. 

  • Bioligcal agents  including Humira that work in conjuction with conventional DMARDs. 

• A nurse will consistently

  1. Assess your joint pain & mobility. 

  2. Assess for signs and symptoms of complications such as osteopenia.

  3. Adherence of care plan. 

  4. Educate on signs and symptoms of infection. 

  5. Consult infectious disease specialists for chronic or atypical infections. 

  6. Educate on importance of staying up to date with vaccinations.

  7. Consult physical and occupational therapies as needed.