Rheumatoid arthritis is a chronic inflammatory condition that occurs as a result of an autoimmune process caused by the immune system. Antibodies are produced which attack the normal tissue covering the joints, called the synovium, and this results in persistent inflammation which results in swelling and leads to damage of the involved joints. The most commonly involved joints are those of the wrists, hands and fingers. Not only are joints involved, but so are other areas of the body such as the eyes, heart, lungs, blood vessels and the skin.
The mechanism of the autoimmune reaction that damages these joints isn’t clearly understood, but there are certain risk factors associated with the development of rheumatoid arthritis. These include having a family history of the condition, being female and between the ages of 40 and 60, smoking cigarettes, obesity, and environmental factors such as exposure to silica and asbestos.
There is no cure for rheumatoid arthritis, but there are effective management protocols available to help reduce the symptoms of the condition. The rationale of managing this condition is to try and diagnose it as early as possible and to administer medications, known as the disease-modifying anti-rheumatic drugs (DMARDs), as this is more likely to help keep the patient in remission. Non-steroidal anti-inflammatory medications such as ibuprofen, diclofenac and naproxen, as well as steroids such as prednisone are used to help relieve pain caused by the condition.
If oral drugs are ineffective, then surgical options such as joint fusion, synovectomy, tendon repair, or a joint replacement may be warranted.
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The best medical centers in the United States, where patients with rheumatoid arthritis are diagnosed and managed, are located mainly on the eastern part of the country. These are internationally renowned hospitals with world-class facilities that offer comprehensive services, and may already be known to many patients. We shall mention these centers as well as some of the best doctors who specialize in managing rheumatoid arthritis.
New York-Presbyterian Hospital, New York, NY: The rheumatology department at New York-Presbyterian hospital provides state-of –the-art care to patients who suffer from a wide range of autoimmune conditions. Comprehensive medical training is offered to student doctors and specialists-in-training, as well as conducting groundbreaking studies at laboratory level and via clinical studies. The Division of Rheumatology at this facility is the largest program in the United States with more than 30 full time specialist rheumatologists and 3 pediatric rheumatologists working there. They consult more than 10,000 new patients and follow-up with over 30,000 existing patients on an outpatient and inpatient basis annually. This program also performs more than 70 clinical research studies and trials every year, providing patients with access to medications not yet available elsewhere. Some of the top-rated rheumatologists working at New-York Presbyterian’s rheumatology department include Dr Jon T Giles, Dr Joan M Bathon, Dr Edward Dwyer and Dr Dimitrios Pappas.
Mayo Clinic Hospital, Rochester, MN: The Mayo Clinic in Rochester is one of the best medical research facilities in the United States. The specialists working at this facility provide excellent and up-to-date services for patients diagnosed with rheumatoid arthritis, as well as other chronic inflammatory and autoimmune diseases affecting the human body. The services offered by the program include outpatient services, specialty care for patients diagnosed with chronic rheumatic disease, hospital inpatient consultations, outreach services to satellite and rural clinics, and performing clinical trials to develop new treatments. Special investigations and specialized services offered by this program include diagnostic and interventional musculoskeletal ultrasound for more accurate diagnoses, and the injection clinic where diagnostic and therapeutic soft tissue and intrarticular aspirations and injections are performed. Top-rated specialist rheumatologists working at Mayo Clinic’s rheumatology program include Dr John M Davis, Dr Eric L Matteson, Dr Clement J Michet and Dr Kerry A Wright.
Brigham and Women’s Hospital, Boston, MA: Brigham and Women’s hospital’s rheumatology department was ranked number 5 in the United States by U.S. News & World Report in 2016-2017. The rheumatology specialists at this facility provide comprehensive, innovative and unique diagnosis and management for patients diagnosed with conditions such as rheumatoid arthritis. This program also runs team-based care clinics where the clinicians work together with the rheumatology specialists of the facility to provide multidisciplinary care to patients who struggle with complex rheumatic conditions. A few of the top-ranked rheumatoid arthritis specialists consulting with patients at Brigham and Women’s hospital include Dr Michael E Weinblatt, Dr Jonathan S Coblyn, Dr Elena M Massarotti, Dr Nancy A Shadick and Dr Daniel H Solomon.
University of Alabama Hospital, Birmingham, AL: The University of Alabama hospital in Birmingham (UAB) is consistently ranked as having one of the top 12 rheumatology programs in the United States by U.S. News & World Report. This is an internationally recognized facility that is dedicated in progressing knowledge and using data from their research studies to improve diagnosis and management of patients who suffer from conditions such as rheumatoid arthritis. The rheumatology program at UAB in one of the largest in the country, and specialists log more than 10,000 annual visits, assessing and managing patients with various types of autoimmune and connective tissues disorders. The staff incorporates a multi-disciplinary approach towards patient care so that everyone that consults with them receives individualized management of their condition. The Interdisciplinary Infusion Center at the hospital provides readily available FDA-approved intravenous treatments for various rheumatic illnesses. Some of the highly rated specialists at UAB include Dr Jeffrey R Curtis, Dr Laura B Hughes, Dr Maria I Danila and Dr Kenneth G Saag.
University of Michigan Health System, Ann Arbor, MI: The Division of Rheumatology at the University of Michigan offers consultations, diagnosis and management of conditions such as rheumatoid arthritis. Diagnostic and therapeutic procedures performed by healthcare professionals at this facility include arthroscopies, arthrocentesis, synovial fluid analysis, closed synovial biopsy, and ultrasound investigations. Top-rated rheumatologists who evaluate and manage patients with rheumatoid arthritis at this center include Dr David A Fox, Dr Joseph Holoshitz, Dr Robert W Ike and Dr Wendy Marder.