RHEUMATOID ARTHRITIS Wendy Kuhns Northern Arizona University
Symptoms, Treatment and Incidence
Slide 3
GENERAL SYMPTOMS Painful Swelling in Joints Fatigue Loss of
Function Joint Erosion Decreased Range of Motion Physical
Deformity
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WHAT IS RHEUMATOID ARTHRITIS? A chronic non-contagious,
non-infectious autoimmune disorder for which there is currently no
cure. Rheumatoid arthritis causes the immune to mistakenly attack
health cells and tissues. More prominent in women then men aged 30
to 50 years of age at a 3:1 ratio Positively identified by
increased levels of inflammation in the blood and the presence of
the rheumatoid factor (RF) Prolonged inflammation leads to joint
erosion, physical deformity and organ damage (Smolen, 2008)
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RA SYMPTOMS PROGRESSION (Rennie, Hughes, Lang, Jebb, 2010)
Joint swelling, stiffness and redness are the hallmark symptoms for
those suffering from rheumatoid arthritis. Early symptoms are dry
mouth, inflamed eyes, difficulty sleeping and general weakness or
fatigue. Fatigue, swollen joints, especially the hands and ankles,
and stiffness are the common complaints. Flu-like symptoms,
prolonged fevers without causation. Nodules form in about 20% of
people. These nodules are caused from inflammation of small blood
vessels. Usually the size of a pea, they are commonly located near
the elbow however they can show up anywhere.
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DIAGNOSIS Rheumatologists prefer to utilize 2 standard lab
tests to help in the diagnosis of the disease: Rheumatoid factor
and Anti-cyclic Citrullinated Peptide (Anti-CCP) antibody. The
rheumatoid factor (RF) test measures the amount of RF antibody in
the blood through sampling blood from a vein on the inside of the
elbow or the back of the hand. Those with a low number or normal
result, usually less than 40-60 u/mL, are not considered to have
rheumatoid arthritis, however 61 u/mL and above are diagnosed with
having the disease. those with high RF levels will usually be
referred for more tests such as the Anti-CCP antibody blood test
which is used on individuals who tested on the high side of
rheumatoid factor levels. History has shown this antibody has been
present in 70% of patients and it can be detected between 1.5 and 9
years prior to the onset of symptoms Rheumatologists prefer to
utilize 2 standard lab tests to help in the diagnosis of the
disease: Rheumatoid factor and Anti-cyclic Citrullinated Peptide
(Anti-CCP) antibody. The rheumatoid factor (RF) test measures the
amount of RF antibody in the blood through sampling blood from a
vein on the inside of the elbow or the back of the hand. Those with
a low number or normal result, usually less than 40-60 u/mL, are
not considered to have rheumatoid arthritis, however 61 u/mL and
above are diagnosed with having the disease. those with high RF
levels will usually be referred for more tests such as the Anti-CCP
antibody blood test which is used on individuals who tested on the
high side of rheumatoid factor levels. History has shown this
antibody has been present in 70% of patients and it can be detected
between 1.5 and 9 years prior to the onset of symptoms (Visser,
Cessie, Vos, Breedveld, & Hazes, 2002, p. 363)
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STAGES OF RA DISEASE PROGRESSION Begins slowly. Symptoms come
and go Persistent swelling in hands with joint stiffness Joint
erosion, permanent physical deformity especially in the hands
(Rennie, Hughes, Lang, Jebb, 2010)
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STAGES OF RECOVERY, DISABILITY, OR DEATH Since there is
currently no cure for rheumatoid arthritis, so people will not
experience a full recovery. RA Flares are when symptoms are being
experienced but usually dissipate after a week or 2. Treatment for
RA is aimed at reducing inflammation, preventing damage to bones
and ligaments, and preserving range of motion through medications
and joint injections. Surgical interventions can be helpful for
individuals who have severe deformities and disabilities. People
diagnosed with RA usually do not experience shorter life spans due
to rheumatoid arthritis, however they do seem to have higher risks
of developing serious diseases such as infections and cancers as
well as heart, lung and stomach problems due to the medications,
such as azathioprine and corticosteroids. Since there is currently
no cure for rheumatoid arthritis, so people will not experience a
full recovery. RA Flares are when symptoms are being experienced
but usually dissipate after a week or 2. Treatment for RA is aimed
at reducing inflammation, preventing damage to bones and ligaments,
and preserving range of motion through medications and joint
injections. Surgical interventions can be helpful for individuals
who have severe deformities and disabilities. People diagnosed with
RA usually do not experience shorter life spans due to rheumatoid
arthritis, however they do seem to have higher risks of developing
serious diseases such as infections and cancers as well as heart,
lung and stomach problems due to the medications, such as
azathioprine and corticosteroids. (Starkbaum, 2014), (Killian,
2015). Movement is key to decreasing painful stiffness
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INCIDENCE RATES OF RA IN THE UNITED STATES Overall current and
year 2010 prevalence rate of rheumatoid arthritis for the United
States was an estimated 1.5 million adults in 2010 compared to 1.3
million people in 2014 Incidence rate based on gender was
significantly higher in women than in men in both 2010 and 2014.
26% of women and 19% of men are diagnosed with RA. Never has yearly
incidence been higher in men than in women In 2010, 3.7% of
Caucasians, 4.3% African Americans, and 2.7% Hispanics were
diagnosed with rheumatoid arthritis. In 2014, prevalence rates
increased slightly amongst =the Caucasian population to 3.9% In
2010, 151 per 100,000 women were diagnosed with RA between the ages
of 45-65 and 41 per 100,000 of men within the same age compared to
103 per 100,000 of women and 40 per 100,000 of men in 2014
Rheumatoid arthritis is common throughout the United States. In
both 2010 and 2014 a statistically significant area of increased
risk was identified in the upper northeast including Vermont, New
Hampshire, and southern Maine. An area of decreased risk was
located in Pennsylvania. The Midwest (Great Plains), northern
Maine, and southwest Texas as low population density regions
(Vieira, 2014). (Silman, 2014), (Starkbaum, 2014)
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To qualify for this survey, participants had to be RA patients
over 18 years old and a US resident or US citizen (RA.Net,
2013)
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INSIGHTS AND TRENDS OF RA IN THE UNITED STATES Managing
symptoms affectively can not only reduce the chronic pain
associated with RA, but is can help improve the quality of life for
those people who are suffering with the disease. History has shown
that women are more prone to developing rheumatoid arthritis at an
ratio of 2.7:1 versus that of men however it is not understood why
this is. One trend that is particularly interesting is the lower
prevalence of RA diagnosis in rural areas and significantly higher
RA prevalence in high density areas such as the Northeastern United
States especially Vermont and Maine. It can be questioned whether
air quality and other common city pollutants can contribute to
onset and progression of rheumatoid arthritis. Managing symptoms
affectively can not only reduce the chronic pain associated with
RA, but is can help improve the quality of life for those people
who are suffering with the disease. History has shown that women
are more prone to developing rheumatoid arthritis at an ratio of
2.7:1 versus that of men however it is not understood why this is.
One trend that is particularly interesting is the lower prevalence
of RA diagnosis in rural areas and significantly higher RA
prevalence in high density areas such as the Northeastern United
States especially Vermont and Maine. It can be questioned whether
air quality and other common city pollutants can contribute to
onset and progression of rheumatoid arthritis. (Wong & Davis,
2013, p. 23)
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FOR MORE INFORMATION Peter Walsh Peter Walsh Design, Inc.
www.peterwalshdesign.com www.peterwalshdesign.com
[email protected][email protected] Replace
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audience.
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REFERENCES CDC - Arthritis - Data and Statistics - Arthritis
Related Statistics. (n.d.). Retrieved from
http://www.cdc.gov/arthritis/data_statistics/arthritis_related_stats.htm
Killian, M. (2015). Myths and misconceptions about rheumatoid
arthritis. American Nurse Today, 5(7). Rennie, K. L., Hughes, J.,
Lang, R., & Jebb, S. A. (2012). Nutritional management of
rheumatoid arthritis: a review of the evidence. Journal of Human
Nutrition and Dietetics, 4, 1- 15. Silman AJ, Hochberg MC.
Epidemiology of the Rheumatic Diseases. 2nd ed. New York: Oxford
University Press; 2001 Smolen, A. (2008). Rheumatoid Arthritis -
In-Depth Report - NY Times Health. Retrieved from
http://www.nytimes.com/health/guides/disease/rheumatoid-arthritis/print.html
Starkebaum, G. (2014, January 22). Rheumatoid arthritis - National
Library of Medicine - PubMed Health. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001467/ Vieira, V.
(n.d.). EHP Association between Residences in U.S. Northern
Latitudes and Rheumatoid Arthritis: A Spatial Analysis of the
Nurses Health Study, 2014.