Rheumatoid Arthritis
Also known as: RA
Chronic autoimmune arthritis causing joint inflammation, pain, and potential damage. Diagnosed with labs, imaging, and in-office ultrasound. Treated with DMARDs and biologics.
Key Facts
- Affects approximately 1% of the population worldwide
- Women are 2-3 times more likely to develop RA than men
- Early treatment within the first 3-6 months significantly improves outcomes
- Unlike osteoarthritis, RA is driven by immune dysfunction, not wear and tear
- Can cause systemic effects beyond joints, including lung and eye involvement
What is rheumatoid arthritis?
Rheumatoid arthritis (RA) is a chronic autoimmune disease in which the immune system attacks the lining of the joints, causing inflammation, pain, swelling, and — if untreated — permanent joint damage. Unlike osteoarthritis, which results from mechanical wear, RA is driven by immune dysfunction and can affect any joint in the body, often symmetrically.
RA can also cause systemic effects beyond the joints, including fatigue, low-grade fevers, and inflammation in other organs such as the lungs and eyes.
Symptoms
- Persistent joint pain and stiffness, typically worse in the morning or after rest
- Swelling and warmth in multiple joints, often hands, wrists, and feet
- Morning stiffness lasting longer than 30 minutes
- Fatigue and general malaise
- Symmetric joint involvement (both hands, both knees)
- Over time: joint deformity and loss of function if inadequately treated
How we diagnose it
- Physical exam — Assessing joint tenderness, swelling, and range of motion
- Blood tests — Rheumatoid factor (RF), anti-CCP antibodies, inflammatory markers (ESR, CRP)
- Musculoskeletal ultrasound — Dr. Fellows performs in-office ultrasound to detect synovitis (joint lining inflammation) and early erosive changes that may not yet appear on X-ray. This allows earlier, more confident diagnosis.
- X-rays — Baseline imaging to assess for joint damage
How we treat it
- DMARDs (disease-modifying antirheumatic drugs) — Methotrexate is the cornerstone, often combined with hydroxychloroquine or sulfasalazine
- Biologic therapies — TNF inhibitors, IL-6 inhibitors, T-cell costimulation blockers, B-cell depletion therapy. Many of these are administered as infusions in our on-site infusion center.
- JAK inhibitors — Oral targeted therapies for patients who don't respond to or prefer alternatives to biologics
- Corticosteroid injections — Ultrasound-guided joint injections for targeted flare management
- Monitoring — Regular lab work and periodic ultrasound to track disease activity and medication safety
At Synergy Rheumatology
RA is one of the most common conditions we manage. With in-office ultrasound, we can detect inflammation earlier and monitor treatment response without waiting for outside imaging. When biologic infusions are needed, they happen in the same office where you receive your rheumatologic care. Patients interested in emerging RA therapies may also be eligible for clinical trials conducted at our on-site research center.
Have questions about rheumatoid arthritis?
Schedule an appointment to discuss your symptoms, diagnosis, or treatment options with Dr. Fellows.