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The Joints
A normal joint (the place where two bones meet)
is surrounded by a joint capsule that protects and supports
it (see illustration). Cartilage covers and cushions the ends
of the two bones. The joint capsule is lined with a type of
tissue called synovium, which produces synovial fluid. This
clear fluid lubricates and nourishes the cartilage and bones
inside the joint capsule.
In rheumatoid arthritis, the immune system, for
unknown reasons, attacks a person's own cells inside the joint
capsule. White blood cells that are part of the normal immune
system travel to the synovium and cause a reaction. This reaction,
or inflammation, is called synovitis, and it results in the
warmth, redness, swelling, and pain that are typical symptoms
of rheumatoid arthritis. During the inflammation process,
the cells of the synovium grow and divide abnormally, making
the normally thin synovium thick and resulting in a joint
that is swollen and puffy to the touch (see illustration).
As rheumatoid arthritis progresses, these abnormal
synovial cells begin to invade and destroy the cartilage and
bone within the joint. The surrounding muscles, ligaments,
and tendons that support and stabilize the joint become weak
and unable to work normally. All of these effects lead to
the pain and deformities often seen in rheumatoid arthritis.
Doctors studying rheumatoid arthritis now believe that damage
to bones begins during the first year or two that a person
has the disease. This is one reason early diagnosis and treatment
are so important in the management of rheumatoid arthritis.
 A joint (the place where two bones meet) is surronded
by a capsule that protects and supports it. The joint capsule
is lined with a type of tissue called synovium, which produces
synovial fluid that lubricates and nourishes joint tissues.
In rheumatoid arthritis, the synovium becomes inflmaed, causing
warmth, redness, swelling, and pain. As the disease progresses,
abnormal synovial cells invade and erode, or destroy, cartilage
and bone within the joint. Surronding muscels, ligaments,
and tendons become weakened. Rheumatoid arthritis can also
cause more generalized bone loss that may lead to osteoporosis
(fragile bones that are prone to fracture).
Other Parts of the Body
Some people also experience the effects of rheumatoid
arthritis in places other than the joints. About one-quarter
develop rheumatoid nodules. These are bumps under the skin
that often form close to the joints. Many people with rheumatoid
arthritis develop anemia, or a decrease in the normal number
of red blood cells. Other effects, which occur less often,
include neck pain and dry eyes and mouth. Very rarely, people
may have inflammation of the blood vessels, the lining of
the lungs, or the sac enclosing the heart.
Occurrence
and Impact of Rheumatoid Arthritis
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