Rheumatoid Arthritis : The Commonest Form Of Inflammatory Arthritis

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Rheumatoid Arthritis (RA) is the commonest form of inflammatory arthritis (Taylor 2007). It affects approximately 1% of the world population (Gibofsky 2012). Several western incidence and prevalence studies (Symmons et al. 2002; Helmick et al. 2008; Neovius et al. 2011; Widdifield et al. 2014; Fina-Aviles et al. 2016; Śliwczyński et al. 2016) of RA have been published, proposing a variation of the disease occurrence among different populations. However, the prevalence and incidence of RA are lessening in the western populations but prevalence remains alike (e.g. Sweden (0.77%) and the UK (0.81%) (Symmons et al. 2002; Neovius et al. 2011). RA is less common in low-income and middle-income countries (0.5% prevalence) compared to western…show more content…
Patients primarily complain of pain, morning stiffness, and edema (swelling) of their peripheral upper limbs and lower limbs joints (Hochberg et al. 2009). The joints most commonly involved initially are the metacarpophalangeal (MCP) joints, proximal interphalangeal joints (PIP), wrist, and metatarsophalangeal joints (Taylor 2007; Harnden et al. 2016). Although RA is primarily affect the musculoskeletal system, the systemic inflammation properties may affect other body organs and systems (Extra-Articular), causing vasculitis, fever, weight loss, fatigue, pleuritic, pericarditis, endocarditis, neuropathies, scleritis, and episcleritis (Cojocaru et al. 2010).

As pointed out previously the presentation and clinical expression of RA is highly variable between patients. Moreover, the signs and symptoms of RA cover a wide-ranging spectrum, varying from pain, stiffness, swelling and functional impairment (Taylor 2007; Heidari 2011; Crawford 2015). Therefore, clinical diagnosis of RA is greatly individualised process (Heidari 2011), which makes it fundamentally hard to establish a uniform diagnostic criteria (Aggarwal et al. 2015). Considering the absence of specific test for diagnosis of RA, the majority of treatment trials published in the last two decades included patients who fulfil the 1987 American College of Rheumatology (ACR) as a diagnostic criteria of RA (van der
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