Rheumatoid Arthritis (RA) is a chronic inflammatory rheumatic disease that tends to affect the smaller joints but may also cause damage in other locations. This condition is also responsible for other systemic alterations, called extra-articular manifestations. RA is responsible for physical disability, progressive joint deformity and significant loss of quality of life and work productivity.
In Portugal, RA is estimated to affect 0.8% to 1.5% of the population. It is two to four times more common in women than in men. The peak incidence in women comes after menopause, but people of all ages can develop the disease, including teenagers.
Despite being an “incurable” disease, there is currently effective treatment to control its inflammatory process. There is consistent scientific evidence demonstrating that proper treatment significantly delays the structural damage caused by the disease and significantly restores part of the patient’s lost physical function.
Once the condition has been diagnosed, the rheumatologist must alert the patient of all its consequences but also highlight that nowadays the disease has a good vital and functional prognosis. For the patient to face the prognosis with optimism, two fundamental conditions must be met: an early diagnosis and regular specialised follow-up.
An early diagnosis is critical since the primary goal of the treatment is to control the disease before damage sets in. With a late diagnosis, sufficient time may have elapsed and deformity of the joint may already have occurred. Once a deformation is established, the damage is irreversible. We can, therefore, state that there is a “temporal window of opportunity” between the onset of the disease and the onset of joint deformation. A timely treatment can be decisive in maintaining the patient’s quality of life.
Follow-up of this disease requires regular evaluation of the therapeutic efficacy and possible adverse effects. The experienced rheumatologist is qualified for these tasks, but also to diagnose and treat conditions that may arise associated with RA, such as osteoporosis and peri-articular disease (tendonitis). These conditions affect a significant proportion of the population, however, the rheumatic patient is particularly predisposed to suffer these consequences. These conditions, along with lower back pain (“backache”) and osteo-degenerative disease (arthrosis), can be diagnosed and effectively treated in an out-patient rheumatology consultation.
To conclude, RA, one of the most paradigmatic diseases in rheumatology, is considered a condition with a good prognosis as long as it is diagnosed and treated early. The pathologies that appear associated with this disease (tendonitis, arthrosis, etc.) must also receive the attention of the rheumatologist, due to the impact they will have on the quality of life of the rheumatic patient.
By Dr. Pedro Carvalho
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Dr. Pedro Carvalho is a Rheumatologist at the HPA Health Group
