Rheumatoid Arthritis
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Rheumatoid Arthritis (RA)

Rheumatology

Rheumatoid Arthritis (RA) is a common rheumatologic disease in Hong Kong, characterized by a chronic inflammatory joint disease caused by an abnormal autoimmune response. This inflammation can affect multiple joints throughout the body, leading to persistent erosion and deformity, eventually destroying joint structures. It not only causes severe pain but also significantly impacts the patient’s mobility, posing a threat to their health and reducing their quality of life.

Symptoms

  • Joint Pain and Swelling: Especially in small joints like the hands and feet.
  • Morning Stiffness: Stiffness in the joints upon waking, typically lasting more than 30 minutes.
  • Fatigue: Frequent feelings of tiredness.
  • Fever and Weight Loss: This may be accompanied by low-grade fever and weight loss.

Causes and Factors

Causes

  • Immune System Abnormalities: The immune system mistakenly attacks joint tissues.
  • Genetic Factors: Certain genes, such as HLA-DRB1, are associated with an increased risk.
  • Environmental Factors: Infections, smoking, and hormonal changes may trigger the disease.

Risk Factors

  • Gender: Women are at higher risk of developing the condition.
  • Age: It commonly manifests between 40 and 60.
  • Family History: Those with a history of the disease have an increased risk.
  • Smoking: Smokers have a higher risk of developing rheumatoid arthritis.

Diagnosis

  • Clinical Examination: The doctor examines joint swelling and pain.
  • Blood Tests: Testing for rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibodies (Anti-CCP).
  • Imaging Studies: X-rays, ultrasound, or MRI to check for joint damage.

The currently established diagnostic criteria were jointly published by the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) in 2010. These criteria include the following four scoring standards, with a total score of 10 points. A result of 6 points or more is considered indicative of Rheumatoid Arthritis (RA).

A. Joint Involvement

1 med / large joint

2 – 10 med / large joint

1 – 3 個 small joint

4 – 10 small joint

> 10 joints (at least 1 small)

0

B. Serology

RF or anti-CCP

- Neither nor positive

- At least one test low positive

- At least one test high positive

 

0

2

3

C. Acute Phases Reactants

CRP & ESR

- Normal

- Abnormal (each or both)

 

0

1

D. Duration of Synovitis

< 6 weeks

> 6 weeks

0

1

⚠️  Diagnosis of rheumatoid arthritis requires the professional judgment of a physician. A comprehensive assessment based on the patient's test results and clinical features is necessary for a definitive diagnosis.

Treatments

Medication Treatment:

  • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Medications that have antipyretic and analgesic effects to reduce pain and inflammation.
  • Corticosteroids: Main drugs for treating rheumatoid arthritis and essential treatment drugs that control inflammation in the short term.
  • Disease-Modifying Antirheumatic Drugs (DMARDs): Primarily control the inflammatory response of rheumatoid arthritis through immune modulation, slowing disease progression.
  • Biologics: Target specific parts of the immune system to control inflammation, with fewer side effects than other medications. Recently, oral forms have been introduced, but they are more expensive.

Physical Therapy: 

  • Guidance from physical or occupational therapists helps improve joint function and reduce stiffness.

Surgery:

  • For severe joint damage, procedures like joint replacement or repair surgeries (e.g., total joint replacement, tendon reconstruction, synovectomy, or joint fusion) are performed to alleviate pain and improve the affected joint's function.

FAQ

Stay Warm: Use heat packs or take a warm bath. Gentle Exercise: Perform joint movements and stretching exercises.
Healthy Diet: Consume adequate fruits, vegetables, and Omega-3 fatty acids. Regular Exercise: Maintain joint mobility and muscle strength. Quit Smoking: Reduce the negative impact of smoking on the immune system.
NSAIDs: May cause gastrointestinal discomfort and ulcers. Corticosteroids: Long-term use can lead to osteoporosis and diabetes. DMARDs and Biologics: May increase the risk of infections and other immune-related side effects.

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HEAL Fertility

HEAL Medical

1331, 13th Floor, Central Building, 1-3 Pedder Street, Central, Hong Kong
Mon - Fri 8:30am - 5:30pm
Sat 9:00am - 1:00pm
Sun & Public Holidays Closed
Contact now

HEAL Oncology

16/F, Entertainment Building, 30 Queens Road Central, Central, Hong Kong
Mon - Fri 9:00am - 6:00pm
Sat 9:00am - 1:00pm
Sun & Public Holidays Closed
Contact now

HEAL Aesthetic

1333, 13th Floor, Central Building, 1-3 Pedder Street, Central, Hong Kong
Mon - Fri 10:00am - 8:00pm
Sat 10:00am - 4:00pm
Sun & Public Holidays Closed
Contact now
HEAL Fertility

HEAL Fertility

10/F, One Chinachem Central, 22 Des Voeux Road Central, Central, Hong Kong
Mon-Fri 9:00am - 6:00pm
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Sun & Public Holidays Closed
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