From the Guidelines
Rheumatoid arthritis primarily affects the small joints of the hands and feet, particularly the metacarpophalangeal joints, proximal interphalangeal joints, and metatarsophalangeal joints, as well as the wrists, elbows, shoulders, knees, ankles, and cervical spine. According to a study published in the Mayo Clinic Proceedings in 2012 1, rheumatoid arthritis is a common autoimmune disease that affects the joints, with clinical features typically including symmetric polyarthritis with joint swelling, especially of the hands and feet. The disease can develop in persons of any age, with the typical age at onset of about 55 years, and can lead to significant disability and shortened life expectancy if left untreated or not properly managed.
Some key points to consider when evaluating the joints affected by rheumatoid arthritis include:
- The disease typically presents with a symmetrical pattern, meaning it affects the same joints on both sides of the body simultaneously
- The small joints of the hands and feet are usually involved first, with symptoms including pain, swelling, stiffness, and warmth
- Any of the appendicular joints may become involved, and the disease can also affect other parts of the body, such as the eyes and lungs
- Morning stiffness that lasts 1 hour or longer is a common symptom of rheumatoid arthritis, as reported in the study published in the Mayo Clinic Proceedings 1
Overall, rheumatoid arthritis is a serious disease that can have significant impacts on a person's quality of life and life expectancy, and prompt diagnosis and treatment are essential to managing the disease and preventing long-term damage to the joints. As noted in the study published in the Mayo Clinic Proceedings 1, more aggressive management of rheumatoid arthritis early after diagnosis and throughout the course of the disease has resulted in improvement in patient functioning and quality of life, reduction in comorbid conditions, and enhanced survival.
From the FDA Drug Label
The results of all four trials were expressed in percentage of patients with improvement in RA using ACR response criteria Study I evaluated 234 patients with active RA who were ≥ 18 years old, had failed therapy with at least one but no more than four disease-modifying antirheumatic drugs (DMARDs) (e. g. hydroxychloroquine, oral or injectable gold, MTX, azathioprine, D-penicillamine, sulfasalazine), and had ≥ 12 tender joints, ≥ 10 swollen joints, and either erythrocyte sedimentation rate (ESR) ≥ 28 mm/hr, C-reactive protein (CRP) > 2. 0 mg/dL, or morning stiffness for ≥ 45 minutes. Study II evaluated 89 patients and had similar inclusion criteria to Study I except that patients in Study II had additionally received MTX for at least 6 months with a stable dose (12. 5 to 25 mg/week) for at least 4 weeks and they had at least 6 tender or painful joints. Study III compared the efficacy of Enbrel to MTX in patients with active RA This study evaluated 632 patients who were ≥ 18 years old with early (≤ 3 years disease duration) active RA, had never received treatment with MTX, and had ≥ 12 tender joints, ≥ 10 swollen joints, and either ESR ≥ 28 mm/hr, CRP > 2. 0 mg/dL, or morning stiffness for ≥ 45 minutes.
The joints associated with rheumatoid arthritis are:
- Tender joints: ≥ 12
- Swollen joints: ≥ 10
- Tender or painful joints: ≥ 6
These joints are not specified by name, but rather by the symptoms they exhibit, such as tenderness, swelling, or pain 2.
From the Research
Joints Associated with Rheumatoid Arthritis
The provided studies do not specifically mention which joints are associated with rheumatoid arthritis. However, we can infer that rheumatoid arthritis is a disease that causes substantial morbidity and mortality, and it affects the synovial tissues, leading to inflammation and tissue destruction 3.
Treatment of Rheumatoid Arthritis
The studies discuss the treatment of rheumatoid arthritis with disease-modifying antirheumatic drugs (DMARDs) such as methotrexate, sulfasalazine, and hydroxychloroquine. Combination therapy with these drugs has been shown to be more effective than single-drug therapy in treating rheumatoid arthritis 4, 5.
Key Points
- Rheumatoid arthritis is a chronic autoimmune disease that affects the synovial tissues 3.
- Combination therapy with DMARDs is more effective than single-drug therapy in treating rheumatoid arthritis 4, 5.
- The disease affects about 0.2-1% of the global population and is a significant cause of disability and labor loss 3.