Rheumatoid arthritis and connective tissue diseases

Publisher Summary This chapter provides an overview of the rheumatoid arthritis (RA) and connective tissue diseases. RA is a common disease found worldwide. It is estimated to affect about 1–2% of the population—prevalence—in the temperate zones with a female to male ratio of 3:1. The condition occurs in families with 11% of probands having at least one affected first-degree relative. A genetic predisposition is further emphasized by the association with HLA (class II)-DR4 that has been demonstrated in numerous studies. RA is a systemic disease. The most common extra-articular manifestation is anemia but patients may present with pathology in any organ. The brunt of the disease is, however, in the diarthrodial joint although some joints are comparatively spared. The classical presentation is that of persistent arthritis—joint swelling—in a symmetrical pattern involving large and small joints. In typical disease, the patient produces antibodies directed against autologous immunoglobulin—rheumatoid factor—and shows joint destruction with the erosion of juxta-articular cartilage and subchondral bone. These patients frequently have numerous extra-articular manifestations of their disease and additional laboratory abnormalities including antinuclear antibodies and cryoglobulins.