Rheumatic Arthritis: The Enemy Within

One of the causes leading to a joint replacement is definitively arthritis. Rheumatic arthritis is a case of the human body’s good intentions gone bad. Your body is equipped with a very effective immune system that fights bacteria and other foreign bodies. Specialized immune cells attack the invaders, surround them, paralyze them, and then destroy them. A strong, intact immune system is essential for your survival. Without it you would quickly become consumed by infections and disease. But if your immune system should suddenly go haywire and start attacking your body’s own tissues, it could become your worst enemy. Such is the case with rheumatic arthritis. When you have it, your immune system attacks the tissue that cushion and line your joints, eventually causing entire joints to deteriorate.

For reasons that are not completely understood, in rheumatic arthritis the white blood cells of the immune system attack the joint lining (synovial membrane) as if it was a foreign object. Pain, loss of movement and joint destruction arise as a result. After the immune system does its job on the joint lining, the following happens:

• The assaulted membrane becomes inflamed and painful, the entire joint capsule swells, and the synovial cell start to grow and divide in an abnormal way.
• Almost as if they were launching a counterattack, these abnormal cells invade the surrounding tissue (mostly bone and cartilage).
• The joint space begins to narrow, and the joint’s supporting structure becomes weak. At the same time, the cells that trigger inflammation release enzymes that start eating away at the bone and cartilage, causing joint erosion and scarring.
• Reeling under this many-sided attack, the joint itself deteriorates, eventually becoming misshapen and misaligned.

Rheumatic arthritis insidiously makes its way through the body and can eventually spread to all the joints. Unfortunately, joints are not its only target. Arthritis is a systematic disease capable of triggering multiple problems in various parts of your body. It can cause inflammation of the membranes surrounding the eyes, heart, lungs, and other internal organs, generally destroying the whole body.

Some people have rheumatic arthritis for just a short time, a few months or a couple of years, and then disappears forever. Others suffer through painful periods that come and go, although they can feel quite well between episodes. Those with severe rheumatic arthritis, however, may be in pain a good deal of time, experience symptoms for many years, and suffer serious joint damage.

Understanding the causes of RA

The truth is that nobody really knows what causes rheumatic arthritis, although some believe it is linked to  a defect in the immune system. Many people with the disease have a particular genetic marker (HLA-DR4) so it is reasonable to suspect these gene may be the one to blame. Yet, not everyone with this gene ends up with rheumatic arthritis and vice versa. Scientists are certain that more than just one gene is involved: perhaps HLA-DR4 is only one of several genes that can tip the scales in favor of developing rheumatic arthritis. Most likely, genetic markers play a part in the development of the disease but are not the determining factor. Some researchers believe that a virus may trigger rheumatic arthritis, or perhaps an unrecognized bacteria that wakes up a dormant genetic defect and sets it in motion. As of yet, no such infections agent has been discovered and the disease itself has not been found to be contagious.

Hormones or hormones deficiencies may also play a part, although their possible role is unclear. Women are more likely than men to develop rheumatic arthritis, suggesting a possible link to estrogen. But, at present, doctors have more questions that answers about it.

If you suspect you are developing some sort of arthritis and want to consult with Dr. Mead, please don’t hesitate to contact us at 239.262.1119.

Orthopedic Corner | Adapted from Arthritis For Dummies | Leon Mead MD Orthopedic Doctor | 730 Goodlette Road North, Suite 201  Naples Florida 34102 | Phone: (239) 262-1119