Rheumatoid arthritis or (RA) is an autoimmune disease that attacks the joints and connective tissue. The result is inflammation that produces permanent damage to the joints. Rheumatoid arthritis is a chronic syndrome that tends to be progressive and destructive compared to osteoarthritis or (OA), which is more of an age-related disease caused by wear and tear on the joints. Unlike rheumatoid arthritis, rheumatoid arthritis is characterized primarily by inflammation of the joints, but is a general disease of the body. The type of joint that is chronically affected is the synovial joint. The bones located at the synovial joint are covered by articular cartilage; which reduces friction and absorbs shock. The space between the articular bones is called the synovial cavity, which is surrounded by a joint capsule. The outer layer of the capsule is called the fibrous capsule and is made up of dense, irregular connective tissue. The internal layer of the capsule is lined by the synovial membrane, which is composed of areolar connective tissue with elastic fibers and may also contain adipose tissue. In a healthy joint the synovial membrane produces synovial fluid. The fluid not only reduces friction and lubricates the joint, but also provides nutrients and removes debris, waste and microbes. Rheumatoid arthritis affects twice as many women as men. It can develop in childhood, but in most cases it develops between the ages of twenty-five and fifty. Rheumatoid arthritis itself may not be hereditary, but what can be inherited are genes that can make you more likely to develop the disease, including those genes that control your immune system. Normally the immune system protects the body from foreign proteins such as bacteria, fungi, or viruses by attacking them and producing antibodies. In rheumatoid arthritis the immune system loses the ability to distinguish between these antigens and normal cells in the body. The body begins to attack normal cells by using plasma cells to produce antibodies called serum rheumatoid factors (RF). Chemical messengers called cytokines control the inflammatory process. One of the key cytokines is called Tumor Necrosis Factor or TNF; which is part of the normal inflammatory process. People suffering from rheumatoid arthritis have been found... middle of paper... pneumonia, bone marrow suppression and, with long-term use, even malignancies. Treatment also includes rest and a nutritious diet. Some supplements such as fish or vegetable oils can be taken to partially relieve some symptoms because they can decrease the production of prostaglandins. Exercise and physical therapy can restore muscle mass and help preserve range of motion. This is recommended after the inflammation has subsided. Another alternative if or when medications fail is arthroscopic or surgical synovectomy, which temporarily relieves inflammation. Prosthetic joint replacement is possible, but this significantly reduces functionality. Rheumatoid arthritis affects everyone differently. In most patients, joint symptoms develop gradually over several years. In some people, rheumatoid arthritis can progress rapidly. Other people may suffer from rheumatoid arthritis for a limited period of time and then enter a period of remission. More than two million people in the United States alone suffer from rheumatoid arthritis, and with research and development of new drugs and gene therapy there may be a clearer picture of patients' future and quality of life..