MEDICAL ANIMATION TRANSCRIPT: Bones provide support for the body and aid in its movement. The place where two or more bones meet is called a joint. Joints may be immovable, slightly movable, or freely movable. A synovial membrane surrounds movable joints. Inside the membrane, synovial fluid lubricates and nourishes join tissue, such as cartilage. Articular cartilage is a tough slippery covering on the ends of the bones, which allow smooth joint movement. Joints give the body flexibility, precision of movement, and help in supporting the body's weight. Arthritis is any disorder that affects joints. It can cause pain and inflammation. Rheumatoid arthritis is the second most common type of arthritis. The joints most commonly affected are in the wrists, hands, knees, ankles, and feet. It typically occurs at the same joint on both sides of the body. It can also affect other organs in the body, such as the eyes, skin, heart, lungs, kidneys, nervous system, and digestive tract. Rheumatoid arthritis is an autoimmune disorder. This means the body attacks itself by mistake. In rheumatoid arthritis, the immune system attacks joint and organ tissues. Here's how it happens, the white blood cells of the immune system move into the joint. They release chemicals called cytokines, which attack the cells of the synovial membrane. These chemicals cause synovial cells to release other destructive substances. They also cause the synovial membrane to grow new blood vessels and form a thickened area called a panous. Over time, as the panous grows, it invades and destroys areas of cartilage and bone inside the joint. Inflammation causes fluid buildup in the joint, making the joint swell. Eventually without treatment, the joint space narrows and ankylosis can occur. Ankylosis is fusion or growing together of bones in the joint. This results in the loss of the ability to move the joint. There is no cure for rheumatoid arthritis. However, doctors commonly prescribe various combinations of the following medications that when taken together can reduce inflammation and pain, and slow down joint damage. These include, non-steroidal anti-inflammatory drugs, or NSAIDs, steroids, and standard disease modifying antirheumatic drugs, or DMARDs. If standard DMARDs aren't working, doctors may prescribe newer drugs called biologics, also known as biologic DMARDs. Physical and occupational therapy along with low impact exercise can increase muscle strength and help keep joints limber. For severe rheumatoid arthritis that has not been helped by other treatments, a doctor may recommend a surgical procedure. For example, a joint replacement procedure, also known as an arthroplasty, may be recommended. For joints that are difficult to replace, joint fusion, also known as arthrodesis, may be recommended. During this procedure, the joint is removed, and the bones are fused together with bone graft. Another surgical procedure for severe rheumatoid arthritis is a synovectomy. During this procedure, the synovial membrane surrounding the joint is removed. In some cases, an arthritic joint may need to be replaced with an artificial joint. For more information, talk to a health care provider.