|  Find a Doctor   |   Getting to NUH   |  Appointments   |  Contact Us   |  Newsroom  |  About NUH  |  Make a Gift 

University Medicine Cluster

Common Conditions:




High Blood Pressure


High Cholesterol

Chronic Obstructive Pulmonary Disease

Lung Cancer


Obsessive Compulsive Disorder



Rheumatoid Arthritis

What is Rheumatoid Arthritis (RA)?

Arthritis refers to inflammation of joints. RA is one of the most common forms of arthritis. Up to 1% of the general population may be affected by RA and it can happen at any age. RA is more common in women.

What causes RA?

RA is an autoimmune disease. There are some genetic factors; in addition smoking increases the risk of RA. The immune system normally protects us from infection by attacking germs such as bacteria and viruses. However, in people who develop autoimmune diseases, the immune systems is confused and overactive, and attacks our own body.  This causes joint inflammation that will eventually damage the joint, cartilage and surrounding bones. The most commonly affected joints in RA are the small joints of the hands, wrists, ankles and feet; however any joints can be affected.

What are the symptoms of RA?

  • Joint pain and swelling: usually in hands, wrists, ankles, feet
  • Joint stiffness: usually worse in the morning or after rest
  • Other symptoms include tiredness and sometimes loss of appetite or weight.

How is RA diagnosed?

RA is diagnosed based on patients’ symptoms and clinical examination by a doctor. Blood tests showing elevated inflammatory markers are helpful. Often X-rays or ultrasound of the hands or feet may also be done.

What is the treatment for RA?

The symptoms of RA can be alleviated, and joint damage can be prevented by prompt and appropriate treatment.

  • Disease-modifying anti-rheumatic drugs (DMARDs) are the mainstay of treatment. Methotrexate (MTX) is the cornerstone of treatment and is usually prescribed to most patients with RA. In addition, low dose steroids are an important and useful treatment in the early management of RA. Some patients require combination therapy with other DMARDs or with targeted therapy using injectable biologic drugs.

What should I do if I suspect I have RA?

Seek a doctor’s advice. You will be referred to a specialist Rheumatologist who can confirm the diagnosis and start you on appropriate treatment. Once diagnosed, it is important to start treatment as soon as possible. Any delay will result in accumulation of permanent damage to your joints; however this can be prevented with early appropriate treatment.


This condition is managed by the Division of Rheumatology.