What is RA?
the Immune
The Role of
RA: The Body in Turmoil
The Healthy
The RA Joint vs.
The Healthy Joint
RA Joint Symptoms
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What is RA?
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What is RA?
RA (rheumatoid arthritis) is an autoimmune
disease, which means the body is attacking
its own healthy cells and tissues
RA causes pain, swelling, stiffness, and loss of function
in the joints. Over time, the inflammation of RA can cause
damage to the joints.
An estimated 1.3 million Americans have RA
RA is 2.5x more common in women
RA often begins between the ages of 30 and 50
RA is associated with a high disability rate
RA is a life-long autoimmune disease that progresses over time and could
potentially affect other parts of the body
No one knows exactly what causes some people, but not others, to develop RA
Understanding the
Immune System
The immune system is a complex network
of cells and cell components that interact
with each other to defend the body
against infections
Circulating white blood cells,
"leukocytes," patrol for foreign
invaders such as bacteria
or viruses
When white blood cells encounter such
invaders, they trigger an immune response
that results in their destruction and removal
Any "foreign" or "non-self" cells are
considered dangerous to the body
Inflammation can occur when white blood
cells release cytokines.
The Role of Inflammation
Inflammation is the body's normal
response to foreign invaders, such as
bacteria and viruses
As part of the immune response, white blood cells release
molecules, "cytokines," into the bloodstream
Some of these cytokines act as messengers of the
immune system, specifically to promote inflammation
Inflammation helps the body contain the infection
so it does not spread
The inflammatory response is self-regulated; once the
foreign invader is removed, healing begins and the
inflammation goes away
Redness, swelling, and
pain are hallmarks of
Healthy cells and tissue are attacked as though they
were potentially harmful
When the body attacks itself, the "foreign" substance
can never be removed, so it sets off the same
inflammatory response — over and over again
RA is an autoimmune disease, in which cells and tissues
of the body are affected, primarily, those in the joints
Temporary inflammation means the
immune system is doing its job —
but long-term inflammation can be
In RA, cytokines
are released over
and over again.
The Body in Turmoil
In autoimmune diseases, the immune
system mistakes some normal part
of the body as "foreign"
The Healthy Joint
The synovium is crucial to the health
of the joint and is often the first area
targeted by RA
Joint capsule
encloses the joint to protect and
support it.
Synovial Fluid
lubricates and nourishes the cartilage
and bones inside the joint capsule.
is the thin layer of tissue lining
the joint capsule.
helps reduce the bone friction during
joint movement.
meet at the joint.
Tendons and ligaments
help support the joint.
The RA Joint vs
causes the normally thin synovium to become thicker,
which can cause the joint to swell. The swollen lining
grows into a thick mass, called a "pannus".
Cartilage destruction
begins as the pannus grows.
This may weaken the
muscles, ligaments, and
Bone erosion
occurs over time as inflammation continues.
In severe RA, which may take many years, the edges
of the bones meet and may partially fuse. Eventually, the
joint may become less and less able to work normally.
The Healthy Joint
Joints affected in RA
Even when the symptoms
improve, RA may still
be causing damage to
RA: Joint Symptoms
Joint damage may begin within
the first year or two of RA
Even when
symptoms improve,
RA may still be
causing damage
to joints.
In the earlier course of disease, systemic inflammation
can cause symptoms similar to those seen with a
cold or flu
Periods of worsening joint symptoms (called "flares")
may alternate with periods of "remission" when
symptoms fade or disappear
Small joints — particularly, wrists and fingers — tend to
be affected first
As RA progresses, symptoms may spread to larger joints

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