1. Rheumatoid Arthritis Slideshow Pictures
2. Take the RA Quiz
3. Rheumatoid Arthritis Exercises Slideshow

Medical Author:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

Catherine Burt Driver, MD

Catherine Burt Driver, MD

Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.

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In this Article

• Rheumatoid arthritis (RA) facts
• What is rheumatoid arthritis (RA)?
• What are causes and risk factors of rheumatoid arthritis?
• What are rheumatoid arthritis symptoms and signs?
• What are complications of rheumatoid disease?
• How is rheumatoid arthritis diagnosed?
• What is the treatment for rheumatoid arthritis?
• "First-line" rheumatoid arthritis medications
• "Second-line" or "slow-acting" rheumatoid arthritis drugs
• What are newer treatments for rheumatoid arthritis?
• What about rheumatoid arthritis and pregnancy?
• Rheumatoid arthritis diet and other treatments
• What is the prognosis (outlook) for patients with rheumatoid arthritis?
• Can rheumatoid arthritis be prevented?
• What research is being done on rheumatoid arthritis?
• Where can people get additional information on rheumatoid arthritis?
• Rheumatoid Arthritis Slideshow
• Take the RA Quiz
• Rheumatoid Arthritis Exercises Slideshow
• Newly Diagnosed Rheumatoid Arthritis Treatment
• Rheumatoid Arthritis FAQs
• Patient Comments: Rheumatoid Arthritis - Early Symptoms
• Patient Comments: Rheumatoid Arthritis - Treatments
• Patient Comments: Rheumatoid Arthritis - Experience
• Patient Comments: Rheumatoid Arthritis - Prognosis
• Patient Comments: Rheumatoid Arthritis - Diagnosis
• Find a local Rheumatologist in your town
• Rheumatoid Arthritis Index

With early, aggressive treatment, the outlook for those affected by rheumatoid arthritis can be very good. The overall attitude regarding ability to control the disease has changed tremendously since the turn of the century. Doctors now strive to eradicate any signs of active disease while preventing flare-ups. The disease can be controlled and a cooperative effort by the doctor and patient can lead to optimal health.

Patients have a less favorable outlook when they have deformity, disability, ongoing uncontrolled joint inflammation, and/or rheumatoid disease affecting other organs of the body. Overall, rheumatoid arthritis tends to be potentially more damaging when rheumatoid factor or citrulline antibody is demonstrated by blood testing.

Currently, there is no specific prevention of rheumatoid arthritis. Because cigarette smoking, exposure to silica mineral, and chronic periodontal disease all increase the risk for rheumatoid arthritis, these conditions should be avoided.

Scientists throughout the world are studying many promising areas of new treatment approaches for rheumatoid arthritis. Indeed, treatment guidelines are evolving with the availability of newer treatments. These areas include treatments that block the action of the special inflammation factors, such as tumor necrosis factor (TNFalpha), B-cell and T-cell function, as well as interleukin-1 (IL-1), as described above. Many other drugs are being developed that act against certain critical white blood cells involved in rheumatoid inflammation. Also, new NSAIDs with mechanisms of action that are different from current drugs are on the horizon.

Better methods of more accurately defining which patients are more likely to develop more aggressive disease are becoming available. Recent antibody research has found that the presence of citrulline antibodies in the blood (see above, in diagnosis) has been associated with a greater tendency toward more destructive forms of rheumatoid arthritis.

Studies involving various types of the connective tissue collagen are in progress and show encouraging signs of reducing rheumatoid disease activity. Finally, genetic research and engineering is likely to bring forth many new avenues for earlier diagnosis and accurate treatment in the near future. Gene profiling, also known as gene array analysis, is being identified as a helpful method of defining which people will respond to which medications. Studies are under way that are using gene array analysis to determine which patients will be at more risk for more aggressive disease. This is all occurring because of improvements in technology. We are at the threshold of tremendous improvements in the way rheumatoid arthritis is managed.