A chronic inflammatory disease Women are affected 2 to 3 times more often than men The exact cause of RA is unknown, but it involves an attack on the body by its own immune cells. The disease mainly affect joints, however, it can also affect the muscle, lung, skin, blood vessels, nerve, eye and other oragn etc. Normally, there is a layer of synovial membrane lines the ligamentous surfaces of articular capsules or tendon sheaths which secretes synovial fluid to lubricate the joints. They are necessary for free movements. During RA, the synovium becomes inflamed, it secretes more fluid and the joint becomes swollen. In severe cases, the cartilage becomes rough and pitted, the underlying bone eventually becomes affected. Joint destruction, cartilage destruction, bone erosions and tendon inflammation and rupture resulted and eventually lead to deformity, muscle atrophy or other disabilities. Symptoms can be classified into “active stage” or “ relaxation stage” Active Stage: - Tiredness, loss of appetite, anemia - Morning stiffness - Redness, hotness, and swelling of joints - Multiple joint inflammation which are often symmetrical Relaxation Stage: - All the symptoms mentioned above will appear, but the degree of severity is lower Three of more of the following joints being affected, and last for at least 6 months > Arm, or finger joints > Knee joints > Wrist joints > Hip joints > Elbow joints > Ankle joints > Spine “Morning stiffness” which last for at least 1 hour or more Often symmetrical Positive rheumatoid factor test Erosion of joints can be seen in X rays Activities of daily living is affected, resulting in inability to carry out such activities without assistance Ensure enough rest Medication: NSAIDs, DMARDs, steroids Physiotherapy or occupational therapy