Why “complications of Rheumatoid Arthritis” is an irritating phrase

As I read news articles and journal abstracts on Rheumatoid Arthritis almost every day, I am annoyed at the use of the phrase “complications of Rheumatoid Arthritis.” Rheumatoid Arthritis is a complicated autoimmune disease which can attack almost any part or system of the human body. Scientists can describe certain effects of the disease that have been observed up close, but they have no idea what causes the process of Rheumatoid Arthritis to begin or how it actually happens.

Did you read here last week about the newest standards for diagnosing RA ? One rheumatologist had commented about the existing RA diagnostic criteria that “Satisfying the 1987 criteria is bad news. No one waits till the disease becomes erosive to start disease modifying therapy” (Doctor Alan J. Stilman in a post on EGMN blog.) The mental picture of Rheumatoid Arthritis that most doctors, researchers, and writers still seem to have is reflected in those criteria:

RA is primarily a hand disease which causes swelling and deformity of hands and wrists, also creating a persistent state of inflammation which can be detected by ESR or CRP. Eventually, Rheumatoid Arthritis can affect other joints.

They are calling the actual disease a complication of the disease

I have heard the “hand disease” statement from doctors. This is also the picture of Rheumatoid Arthritis that most in the news media seem to paint. That is why they frequently use the phrase “complications of Rheumatoid Arthritis.” They seem to think that the hands are attacked first, then other joints – and then, sometimes, other systems of the body. They call any illness or deformity which actually reflects the complexity of the disease a “complication” of the disease.

However, as Dr. Silman affirmed, the RA of that picture is one that is more advanced: it is “bad news” because the disease has advanced enough that permanent damage has begun to occur. The hands which reflect obvious Rheumatoid Arthritis are not the hands of early RA. That is one reason that I have asked RA’ers to share their Onset Stories to begin to paint a clearer picture of early RA.

Just a few examples of so-called complications of Rheumatoid Arthritis: Sjögren’s syndrome, loss of voice, iritis, pleurisy, vasculitis, osteoporosis, and heart disease or inflammation.

It’s not that complicated to grasp: these are secondary Rheumatoid Arthritis symptoms

If I’m driving to Wal-Mart, and I get a flat tire, that is something that “complicates” my trip because it has nothing to do with the purpose of it. But if my long shopping list is the reason that I’m late getting back, that is not a “complication” because buying whatever’s on the list was the purpose of my trip to begin with. It’s not too complicated to distinguish.

Correcting the terms used to characterize RA may make a difference

Early Rheumatoid Arthritis is still difficult to identify because most do not know what to look for. I have begun to wonder whether hands are affected most obviously because they are most used. However, they may not actually be the first thing attacked.

1. Correcting the use of the term “complications of RA” could help patients and doctors to think about the disease differently, improving diagnosis.
2. Understanding the mechanisms of Rheumatoid Arthritis will be the first step on a journey toward a cure for Rheumatoid Arthritis. Researchers may be able to see accurate portrayals of early RA as clues as to how it begins.
3. Accurately describing Rheumatoid Arthritis could go a long way at curing the awareness problem we have with RA.

Stay tuned for articles in a series on complications of Rheumatoid Arthritis which I may just call RA Is Complicated. Here is part one in the new series Cricoarytenoid Arthritis in R A (Rheumatoid Arthritis), part 1.

Related posts:

My Quest for Answers to Questions About Rheumatoid Arthritis

Mortality and Rheumatoid Arthritis

To Tell the Truth: Will the Real Rheumatoid Arthritis Please Stand Up?

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This entry was posted on Tuesday, October 27th, 2009 at 9:35 am and is filed under Reality check. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.