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Rheumatoid Arthritis

Symptoms, Diagnosis, & Treatment
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The orthopedic specialists at Hand to Shoulder Center of Wisconsin have experience diagnosing and treating rheumatoid arthritis. If you’re experiencing signs of rheumatoid arthritis, such as swollen or stiff joints, contact Hand to Shoulder Center of Wisconsin in Appleton or Green Bay, WI.

What is Rheumatoid Arthritis?

Rheumatoid arthritis is an autoimmune disease that attacks your body’s cells and tissues. It occurs when your immune system mistakenly attacks the healthy cells and tissues as foreign invaders.

Extreme effects of rheumatoid arthritis

Figure 1: Extreme effects of rheumatoid arthritis

Rheumatoid arthritis, often referred to as “RA”, is one of the most common types of chronic arthritis. It’s a long-term disease that causes inflammation to the lining of the joints, causing painful swelling to the joints and surrounding tissues, which over a long period of time could eventually cause bone erosion and joint deformity (Fig. 1). Rheumatoid arthritis can also affect other organs, such as the skin, eyes, lungs and blood vessels.

The overall causes of rheumatoid arthritis are unclear; however, researchers believe genetics play a key role. Infection and hormone changes may also be a factor.  

Symptoms and Treatments of Rheumatoid Arthritis

Symptoms vary per individual but are often similar to other forms of arthritis and joint conditions.

Rheumatoid arthritis can occur at any age and can affect the whole body; with women being affected three times as often as men. Rheumatoid arthritis symptoms typically attack both sides of the body equally. The most common areas affected by RA include the fingers, wrist, knees, feet and ankles; however, rheumatoid arthritis of the elbow is not uncommon.

Signs of rheumatoid arthritis present slowly and may vary in severity. Rheumatoid arthritis pain typically starts in the smaller joints of the fingers, hands and feet. Stiff hand joints and fatigue are just a few of the common symptoms related to rheumatoid arthritis of the hand and rheumatoid arthritis of the wrist. Additional rheumatoid arthritis symptoms include:

  • Swollen joints that are tender and warm to the touch
  • Morning joint stiffness that may last more than an hour
  • Inflammation with a symmetrical pattern (if one hand hurts the other will also)
  • Rheumatoid nodules (firm bumps of tissue under the skin)
  • Fatigue, fever and possible loss of appetite

When diagnosing rheumatoid arthritis, the physicians at Hand to Shoulder Center of Wisconsin perform a variety of tests including lab work to diagnose and rule out other conditions. Your medical history is reviewed along with a visual and physical examination of the effected upper extremity. In addition, x-rays may be taken to determine if joint damage has occurred. Once RA has been diagnosed, you may be referred to a rheumatologist to further address rheumatoid arthritis treatments.

Although there’s no known cure for rheumatoid arthritis, a select number of treatments for rheumatoid arthritis are available.

At Hand to Shoulder Center of Wisconsin, occupational and physical therapy for rheumatoid arthritis can provide you with specialized treatment goals that focus on pain relief, range of motion, improved loss of joint function and addressing any deformity through splinting/orthotic management. Your orthopedic physician and therapist works hand-in-hand in developing a program to protect your joints without stressing them, including the use of adaptive devices which will help make daily activities easier to perform. Medications such as non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids are often used to ease discomfort. Disease modifying anti-rheumatic drugs (DMARDs) can often help to curb the progression of the disease.

In severe cases, rheumatoid arthritis surgery may be indicated to correct damaged joints and surrounding tissue. Commonly performed surgeries include:

  • Removal of joint lining – the inflamed synovial tissue is removed; typically this is done as part of a reconstructive surgery, although the tissue eventually grows back
  • Tendon reconstruction – damaged tendons are rebuilt
  • Joint replacement – a severely damaged joint is replaced with an artificial joint

The orthopedic surgeons at Hand to Shoulder Center of Wisconsin, Doctors David Toivonen, MD, Jon Cherney, MD, Boyd Lumsden, MD, Scott Olvey, MD, Joseph Cullen, MD, Nathan Van Zeeland, MD, and Matthew Butler, MD have surgical privileges at Woodland Surgery Center and the three Fox Valley hospitals.

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