Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a systemic autoimmune disease in which immune tolerance fails and the synovial lining becomes a persistent target. Activated T cells, B cells, rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) antibodies, and cytokines such as tumour necrosis factor-alpha, interleukin-6, and interleukin-1 sustain inflammation [1]. The inflamed synovium becomes thick, vascular, and invasive. Over time, this tissue can damage cartilage, erode adjacent bone, weaken tendons and ligaments, and restrict joint movement. That is why untreated RA is not simply painful arthritis: inflammation can produce permanent structural loss even when the initial radiograph is normal. RA may also affect the lungs, eyes, skin, blood vessels, and cardiovascular system. A patient’s fatigue, reduced exercise tolerance, or shortness of breath may therefore reflect systemic disease or an extra-articular complication rather than “just sore joints.”