An Overview of the Extraarticular Involvement in Rheumatoid Arthritis and its Management

Rheumatoid arthritis (RA) is an autoimmune systemic disease characterized by long-standing inflammation and significant joint destruction. Despite significant research and success toward the treatment modalities, complete remission still remains a challenge. Even then a number of early and late extraarticular manifestations (EAMs) of the disease further complicate the disease progression. Various EAM encountered in RA can involve more than one organ or system in the body and their clinical features also show lot of variations, mostly involving cutaneous, cardiovascular, and pulmonary systems. The mortality associated with EAM may also be quite high in RA, sometimes more than the disease itself. These EAMs are difficult to diagnose and even more difficult to treat since no clear consensus exists among the rheumatologists as to their correct classification and also due to the fact that no clearcut guidelines are available for their treatment. With this background knowledge, the present review focuses on the various EAMs of RA, their classification, clinical features, and general management overview.