This sheet has been written for people affected by rheumatoid arthritis. It providesngeneral information to help you understand how you may be affected and why early treatment is important. This sheet also covers what you can do to manage rheumatoid arthritis and where to go for further information.

What is rheumatoid arthritis?

Rheumatoid arthritis (RA) is an autoimmune disease that causes pain and swelling of the joints. The normal role of your body’s immune system is to fight off infections to keep you healthy. In an autoimmune
disease, your immune system starts attacking your own healthy tissues. In RA, the immune system targets the lining of the joints, causing inflammation and joint damage. RA usually affects smaller joints, such as the joints in the hands and feet. However larger joints such as the hips and knees can also be affected.

How is it diagnosed?

Your doctor will diagnose RA from your symptoms, a physical examination and various tests. These can include:

blood tests for inflammation
blood tests for antibodies (proteins made by the body’s immune system). Testing for anti-cyclic citrullinated peptide (anti-CCP) and rheumatoid factor can help diagnose RA, although not all people with RA will test positive for these antibodies. See the Blood tests for arthritis information sheet.
x-rays to see if your joints are being damaged by the disease. X-ray changes are rare in the early stages of RA.

It can be difficult, and often takes time, to diagnose RA as the symptoms can be similar to other types of arthritis. If your doctor suspects you have RA you should be referred to a Rheumatologist, a doctor who specialises in arthritis.

What will happen to me?

With early diagnosis and the right treatment, most people with RA can lead full and active lives. However the course of RA varies and no two cases are exactly the same. Many people with RA experience ‘flares’, periods when joints become more inflamed and painful. These can happen with no obvious cause. ‘Flares’ are commonly followed by months or even years when there is little inflammation. RA can cause permanent joint damage and deformity, especially in the first few years of the disease. The good news is that early diagnosis and treatment is shown to limit this type of joint damage.

Is there a cure for RA?

Currently there is no cure for RA. However treatment has improved dramatically over the past 20 years, with new medicines now extremely helpful for people in the early stages of RA. Be wary of any products or therapies that claim to cure RA.

What treatments are there for RA?

Your Rheumatologist will tailor your treatment to your symptoms and the severity of your condition. There is no way of predicting exactly which treatment will work best for you. Your doctor may need to trial several different treatments before finding the one that is right for you and may include:

medicines, such as
- non-steroidal anti-inflammatory drugs (NSAIDs)
- corticosteroid medicines or injections
- disease-modifying anti-rheumatic drugs (DMARDs)
- biological DMARDs.
exercise, to keep the joints flexible and muscles strong. See the Exercise and RA and Working with your healthcare team information sheets.

What can I do?

See a Rheumatologist as early as possible. A Rheumatologist can diagnose RA and make sure you get the right treatment. If you have RA and have not seen a Rheumatologist, ask your doctor about a referral. See the Working with your healthcare team information sheet.

Learn about RA and play an active role in your treatment. Not all information you read or hear about is trustworthy so always talk to your doctor or healthcare team about treatments you are thinking about trying. Self management courses aim to help you develop skills to be actively involved in your healthcare.

Learn ways to manage pain.

Live a healthy life. Stay physically active, eat a healthy diet, stop smoking and reduce stress to help your overall health and wellbeing. See the Exercise and RA and Healthy eating information sheets.

Learn how to protect your joints and cope with tiredness.

Acknowledge your feelings and seek support. As there is currently no cure for RA and it can affect many parts of your life, it is natural to feel scared, frustrated, sad and sometimes angry. Be aware of these feelings and get help if they start affecting your daily life.

© Copyright Arthritis Australia 2007. Reviewed May 2015.
Disclaimer: This sheet is published by Arthritis Australia for information purposes only and should not be used in place of professional advice.

Source: A full list of the references used to compile this sheet is available from your local Arthritis Office. The Australian General Practice Network, Australian Physiotherapy Association, Australian Practice Nurses Association, Pharmaceutical Society of Australia and Royal Australian College of General Practitioners contributed to the development of this information sheet. The Australian Government has provided funding to support this project.

What is a Rheumatologist?

A Rheumatologist is a specialist physician who has expertise in diagnosing and treating diseases of the joints, muscles and bones. Sometimes the term rheumatic disease or ‘rheumatism’ is used to describe this group of diseases.

There are also a number of rarer rheumatic conditions that can affect other parts of the body including the skin, hair and internal organs. These include “lupus”, myositis, vasculitis and scleroderma.

The more common rheumatic diseases include:

Rheumatoid Arthritis
Psoriatic Arthritis
Ankylosing Spondylitis
Gout
Back and neck pain
Osteoarthritis
Muscle and tendon injury/tear
Tendonitis
Fibromyalgia
Polymyalgia Rheumatica
Bone Disease
Osteoporosis
Paget’s disease

What do you charge for consultations?

Initial Consultation Fees

Our full private rate for an initial appointment is $380 (which comes down to $145 after your Medicare Rebate of $234.85 is refunded to you)
Our Health Care Card/Full-time Student/COVID rate is $320 ( (which comes down to $85 after your Medicare Rebate of $234.85 is refunded to you)
Our Pension rate is $290 ( (which comes down to $55 after your Medicare Rebate of $234.85 is refunded to you)

Follow-up/Review Appointment Fees

Our full private rate for a review appointment is $140 (which comes down to $145 after your Medicare Rebate of $67.20 is refunded to you)
Our Health Care Card/Full-time Student/COVID rate for a review appointment is $140 (which comes down to $53 after your Medicare Rebate of $67.20 is refunded to you)
Our Pension rate for a review appointment is $100 (which comes down to $33 after your Medicare Rebate of $67.20 is refunded to you)

Do you Bulk Bill?

We don't bulk bill for appointments with our Rheumatologists. However, we do offer a once-a-week option for you to be seen by a Rheumatology Registrar (a doctor who is close to completing his/her advanced training to become a Rheumatologist). You can be seen by the Registrar, and Dr Peter Landsberg will also meet with you for part of that appointment in his role of supervising the Registrar and to check in on your management plan.

Do you offer Telehealth Appointments?

We definitely do offer Telehealth or online video consultation appointments. Especially in these times of COVID-19 disrupting our ability to set up face-to-face meetings for our immune-suppressed patients. But, we do very much prefer to see you in person for your first appointment.

We believe that this is critical to ensure that we are able to most accurately diagnose and map out the best management plan for your condition. Some things just can't be done well online and we pride ourselves on looking after you as best as we can.

After that initial appointment, once we have met with you and we understand you and your condition, we then feel confident that we can move to Telehealth appointments and offer optimal quality for your ongoing personal care plan.