How to tell if your rheumatoid arthritis is severe

Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes joint inflammation, swelling, pain, stiffness, and in some cases joint deformity. It can lead to long-term health complications.

so Autoimmune diseaseThe body’s immune system mistakenly attacks and damages healthy cells, thinking they are invading them. RA is a progressive disease that can have a significant impact on well-being over time, especially if symptoms are uncontrolled.

The effects of this disease vary from person to person. As a result, it can be difficult for a doctor to determine how serious a person’s condition will be. However, if certain factors, such as the number of affected joints, serum status (presence or absence of specific antibodies in the blood), and inflammatory markers (a method of assessing disease progression), can help predict the severity of RA. there is.

The sooner a person with rheumatoid arthritis begins treatment, the better his overall health will be, as the symptoms of rheumatoid arthritis can worsen over time.

Number of joints affected

The number of joints affected determines the severity of RA. In early rheumatoid arthritis, rheumatoid arthritis tends to affect the body symmetrically, so pain may occur only in both wrists, for example. However, over time, more joints will also be affected.

RA usually affects smaller joints, such as the joints of the fingers and feet, and then progresses to larger joints, such as the ankles, knees, elbows, hips, and shoulders.

The American College of Rheumatology (ACR) and the European League Against Rheumatology (EULAR) have developed the ACR / EULAR classification criteria to confirm the diagnosis of rheumatoid arthritis. An overall score of 6 out of 10 strongly indicates that you have rheumatoid arthritis. The higher the number, the more serious the RA can be. One of the criteria is joint involvement.

Cyril status

Serum status refers to the presence or absence of detectable antibodies against a particular antigen, as measured by a blood test. In RA, tests look for the existence of so-called things Rheumatoid factor (RF) and Cyclic citrullinated peptide (CCP) antibody..

Test limitations include low sensitivity. This means that incorrect results can be produced. Being seropositive, that is, the detection of RF or CCP antibodies in the body, usually indicates that the symptoms of RA are more severe. Because CCP antibodies are so specific, it is very likely that you have RA in the presence of CCP antibodies.

Serum positive RA

A serum-positive RA indicates that someone has RF or CCP antibodies on a blood test, and that person has a case of more severe RA. People with rheumatoid arthritis who are serum-positive often have symptoms in other parts of the body other than the joints.

For example Nodule It occurs in 20% to 30% of RA cases and almost always occurs in serum-positive RA patients. These nodules are most commonly located near the joints of the arms and elbows, but they also tend to occur in the legs and knees. In rare cases, nodules may form in the lungs, heart, or eyes.

People who have been suffering from active serum-positive RA for years can develop rheumatoid arthritis. This is a condition in which blood vessels become inflamed.

Cellonegative RA

Serum-negative RA indicates a lack of CCP antibodies and RF in the blood. However, this does not necessarily mean that there is no RA.

One study showed that participants in rheumatoid arthritis with negative serologic reactions had a better prognosis and less joint damage due to the disease than individuals with seronegative rheumatoid arthritis. Patients with serum-negative RA also responded better to treatment, albeit with a slower response.

However, seronegative patients also had similar progressive damage, as seen on x-rays, compared to seropositive patients. Therefore, a seronegative condition is not a harmless form of RA. Rather, seronegative patients initially appear to indicate that they have a more active illness.

Inflammation marker

Inflammatory markers such as erythrocyte sedimentation rate and C-reactive protein indicate that there is an inflammatory process in the body when they rise, as in RA.

Erythrocyte sedimentation rate (ESR)

Erythrocyte sedimentation rate Is a blood test that measures how quickly red blood cells (red blood cells) settle on the bottom of a test tube that contains a blood sample. Red blood cells usually settle relatively slowly. Faster speeds may indicate inflammation in the body. ESR is one of the tests used to diagnose RA.

It is unclear whether the results of this test show how severe the symptoms of rheumatoid arthritis in humans are. Some individuals with known RAs have successfully tested their ESR levels.

C-reactive protein (CRP)

C-reactive protein Another test used to measure inflammation in the body. However, research on whether it is a reliable tool for RA evaluation is mixed.

A study that tested CRP levels in a group of nearly 28,000 women who did not show signs of RA prior to the study found that CRP could not predict which women were at risk of developing RA. The same was true even if some women were tested near the time they were actually diagnosed with rheumatoid arthritis.

Body fat can increase levels of CRP. Therefore, when using CRP to measure inflammation in women with RA, high levels of CRP may be due to body fat rather than disease activity.

Rheumatoid Arthritis Severity Scale (RASS)

The Rheumatoid Arthritis Severity Scale is designed to help physicians assess disease activity, dysfunction, and physical injury caused by RA.

Disease Activity Score (DAS)

The Disease Activity Score (DAS) measures disease activity such as swelling and tenderness in 28 joints. The DAS is based on a scale of 1 to 10, with 1 being the least severe and 10 being the most severe. This score helps providers determine the baseline level of RA activity and track how it changes over time throughout treatment.

One review conducted by ACR evaluated measurements that accurately reflected the disease activity of RA. The 28 joint count disease activity score (DAS-28) was one of the final recommendations.

Dysfunction

RA-related joint inflammation and deformity can lead to functional limitation. Functional limitations can cause problems with self-care tasks such as grooming and changing clothes, as well as work, exercise, and social abilities.

Physical damage

Physical injury refers to symptoms such as joint deformity. This is one of the criteria used when assessing the severity of RA. The more joint damage, the longer the distance is along the RA.

How well your body responds to RA drugs

Finding the right drug or set of treatments to control RA is important for slowing the progression of RA. Using the DAS score during the course of treatment will allow your doctor to track your response to the medication.

Everyone is different and you may not respond well to the first treatment offered by your doctor. When this happens, it’s easy to be discouraged. However, this can also be seen as a process approaching finding the right treatment.

Awareness of your quality of life

Physical, emotional, and psychological reactions to symptoms vary from person to person. Do not compare yourself to others or your progress in RA. Your body is unique and that’s what you need to take care of.

You can work with your healthcare provider to assess the severity of RA, track its progress, and develop a personalized treatment plan. One study showed that people with severe rheumatoid arthritis tend to have less awareness of social life, physical function, and overall health.

A word from Verywell

The severity of rheumatoid arthritis can be managed by developing a treatment plan and closely tracking it. The symptoms of RA can affect your quality of life, but treatment can help slow the progression of the disease. Having a strong support network and keeping track of your illness can help relieve the emotional tensions associated with living with a chronic illness.