Rheumatoid diseases share clinical features, and differentiating between them sometimes proves difficult. Inflammation of joint capsules, lung tissue, heart muscle, vascular lining and muscle tissue itself are all common. Skin rashes and kidney involvement are also a part of the picture. Laboratory tests and clinical findings help make the diagnosis and point toward a definitive treatment plan.

Rheumatoid arthritis is perhaps the most common of this group of diseases, and we'll focus on it as a prototype for this set of illnesses. Rheumatoid arthritis is a chronic, systemic, inflammatory disease that affects multiple joints and joint capsules. It can be mild or very severe and affect other body organs and systems. Between 1 and 2% of the population may suffer from rheumatoid arthritis in some form (also known as RA), and females are three times as likely to be affected. RA is quite common at the younger ages, affecting people under the age of 40 in many instances. Susceptibility to rheumatoid arthritis is genetically determined.

RA used to be thought of as a relatively benign disorder which could be controlled by starting with certain treatments and adding medication depending on the severity and reactivity of the disease. Studies have now shown it to be a disease with a strong tendency to shorten life and cause significant disability - as such, treatment often begins very aggressively and early after the diagnosis to prevent permanent damage from appearing early in the course.

The appearance and clinical manifestations of RA are variable, and the onset can vary from sudden to slow and insidious. In the latter, low grade fever, weight loss, easy fatigue, and a feeling of something not being right are the most common, accompanied by nonspecific joint ache and muscle stiffness. The acute onset can be dramatic, with fever, acute pain and joint swelling. It may follow a precipitating event, such as surgery, infection, childbirth, or a severe emotional strain.

Prognosis in rheumatoid arthritis is important in underwriting, and underwriters look to signs that may show a poorer prognosis in trying to assess risk. Some of those signs that indicate active and progressive disease include failure to respond to medication, early and significant x-ray changes in joints, poor functional capacity, involvement of organ systems such as heart and kidneys, very abnormal laboratory results and early age and progression of disease.

The information contained on this page is not intended to provide medical advice, which should be obtained directly from your physician.