Extra-articular manifestations of rheumatoid arthritis

Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory rheumatic disease that can affect almost every system in the body. The course of the disease varies considerably from patient to patient. Some patients have a mild course of the disease, although in the majority of patients the disease leads to progressive joint destruction and disability. In addition to joint symptoms, RA can be associated with extra-articular manifestations, which are rarely inaugural and are rather associated with the more severe forms of the disease. The extra-articular involvement of RA is highly variable, ranging from rheumatoid nodules (the most common) to rheumatoid vasculitis, which is associated with significant morbidity and mortality (49% at five years). Systemic features may dominate the joint manifestations in some individuals and may precede joint involvement. Men are more likely to develop severe systemic involvement and have higher mortality from such complications. Systemic manifestations can be divided into general and organ-specific manifestations; the former often occur early in the disease, while the prevalence of the latter is greater in patients with severe RA of long duration. Specific extra-articular features are common, although their incidence may now be decreasing with more aggressive treatment of the disease at an early stage.

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