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Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a systemic inflammatory disease that primarily affects the joints of the hands and feet. Though some of its symptoms may appear similar to osteoarthritis, RA differs in that it is not caused by wear-and-tear to the joint cartilage. Rather, in patients with RA, the actual lining of the joints is damaged as the disease takes its toll on the body.

In addition to affecting the hands and feet, rheumatoid arthritis can cause problems in the hip, knee, elbow, skin, lungs, blood vessels, and eyes.

Symptoms of Rheumatoid Arthritis

  • Joints that are tender, warm, swollen, or deformed
  • Fatigue, fever, weight loss, loss of appetite, lack of energy
  • Stiffness in the morning (may last for several hours)
  • Rheumatoid nodules: hard tissue lumps and bumps beneath the skin
  • Foot pain, often caused by bunions or hammer toes
  • Anemia (low red blood cell count), causing weakness

In severe cases, patients may have RA-related inflammation in multiple joints, possibly including the cervical spine joints.

Causes of Rheumatoid Arthritis

The cause of rheumatoid arthritis is unknown. Some researchers believe that certain individuals may have a genetic predisposition to the disease. When the body comes into contact with some kind of “trigger” (e.g. infection or other environmental factor), it could cause the errant gene to respond by attacking healthy tissue in the joint. This is only one theory about the possible cause behind rheumatoid arthritis.

Rheumatoid Arthritis Risk Factors

Rheumatoid arthritis may develop at any age, though the disease usually begins during middle age. Women over the age of 40 are at the highest risk for developing RA.

Testing for & Diagnosing Rheumatoid Arthritis

At Hedley Orthopaedic Institute, your rheumatologist may begin the evaluation process by inquiring about your medical history and performing a full physical examination. During the examination, the rheumatologist may test joint mobility, swelling, warmth, and tenderness, and look for rheumatoid nodules.

Next, a Rheumatoid Factor (RF) blood test may be performed. This test measures the amount of RF antibody in the blood. A high RF count may indicate the presence of rheumatoid arthritis or Sjögren’s syndrome. However, high RF count is not necessarily indicative of these diseases in all patients. X-rays may also be taken to visualize the amount of damage sustained in the joints. Many patients may also have an Anti-CCP antibody test (a lab blood test) in the diagnostic process.

According to the American College of Rheumatology, at least four of these seven criteria must be met in order to confirm a diagnosis of RA:

  1. Morning stiffness in the joints lasts at least one hour.
  2. Arthritis of three or more joints lasts at least six weeks.
  3. Arthritis of hand joints lasts at least six weeks.
  4. Arthritis on both sides of the body lasts at least six weeks.
  5. There are rheumatoid nodules beneath the skin.
  6. Rheumatoid factor (RF) is present in a lab blood test.
  7. There is evidence of RA on x-rays.

Treating Rheumatoid Arthritis

Rheumatoid arthritis has no cure. At Hedley Orthopaedic Institute, your rheumatologist may be able to provide symptomatic relief through medication, physical therapy, orthotic referral, and surgical referral.


The first-line approach in treating rheumatoid arthritis typically includes Disease Modifying Antirheumatic Drugs (DMARDs). These drugs, which include methotrexate, leflunomide, and chloroquine, decrease the production of immune cells responsible for swelling and inflammation.

Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, may be used to manage pain. However, long-term use of these drugs is not possible, due to potential stomach and heart problems.

Corticosteroids – administered orally or in the form of an injection – may also be used to treat rheumatoid arthritis.

Biologic Agents

Biologic agents, which are sometimes received in conjunction with medication, are drugs that affect only certain parts of the immune system. These drugs are usually administered via injection beneath the skin or intravenously. Biologic agents for RA include white blood cell modulators, tumor necrosis factor (TNF) inhibitors, and Interleukin-6 (IL-6) inhibitors. Essentially, these drugs are used to reduce inflammation as much as possible in order to relieve joint pain.

Physical Therapy

Your rheumatologist at Hedley Orthopaedic Institute may refer you to a physical therapist or special exercise program that helps maintain joint function and strengthen the surrounding muscles. Some physical therapists may also use hot/cold treatments and electrical stimulation as part of your therapy.


Joints with severe damage may be treated surgically. In some cases, the joint lining may be surgically replaced. Other patients may have a total knee, hip, shoulder, or wrist replacement. At Hedley Orthopaedic Institute, surgeons use some of the world’s most advanced technologies and approaches in joint replacement surgery.

Schedule Your Appointment With a Rheumatologist

If you’re suffering from joint pain and tenderness or any of the symptoms listed above, you may wish to schedule an appointment with a rheumatologist in Mesa. At Hedley Orthopaedic Institute, your rheumatologist can provide state-of-the-art treatment and therapy, all under the same roof as some of Arizona’s best-known orthopaedic surgeons. Rheumatoid arthritis may be treated most effectively when diagnosed early on. Contact us to schedule your appointment.


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