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Patient Education

Rheumatoid Arthritis

A chronic autoimmune condition that attacks the joints — treatable, especially when caught early.

Overview

Rheumatoid Arthritis (RA) is a systemic autoimmune disease in which the body's immune system mistakenly attacks the lining of the joints. Left untreated, it causes progressive pain, deformity and disability. With today's disease-modifying therapies, most patients can achieve remission and live active, pain-free lives — provided treatment begins early.

Symptoms

  • Symmetrical joint pain, most often in fingers, wrists and feet
  • Morning stiffness lasting more than an hour
  • Warm, swollen or tender joints
  • Persistent fatigue, low-grade fever and loss of appetite
  • Rheumatoid nodules under the skin in advanced cases
  • Causes

    • Immune system dysfunction targeting the synovial joint lining
    • Genetic predisposition (family history increases risk)
    • Environmental triggers such as smoking and certain infections
    • Hormonal factors — women are up to three times more likely to develop RA

    Diagnosis

  • Detailed clinical examination of affected joints
  • Blood tests for Rheumatoid Factor (RF) and anti-CCP antibodies
  • Inflammatory markers (ESR, CRP)
  • Ultrasound and X-ray imaging to detect joint erosion
  • MRI when early or subtle inflammation is suspected
  • Treatment Options

  • Disease-Modifying Anti-Rheumatic Drugs (DMARDs) such as Methotrexate
  • Biologic therapies (anti-TNF, IL-6 inhibitors, JAK inhibitors)
  • Short-course corticosteroids for acute flares
  • Physiotherapy and occupational therapy to preserve function
  • Regular monitoring to adjust therapy and prevent joint damage
  • Lifestyle Advice

  • Follow an anti-inflammatory Mediterranean-style diet
  • Stay active with low-impact exercise like swimming and walking
  • Quit smoking — it worsens RA and reduces treatment response
  • Prioritise sleep and stress reduction techniques
  • Attend every scheduled follow-up to keep therapy optimised
  • FAQ

    Common questions about Rheumatoid Arthritis

    In the consultation

    How this condition is managed in clinic

    A look inside daily practice — explaining diagnoses, reviewing imaging, and guiding patients of every age through their care plan.

    X-RAY REVIEW WITH PATIENT
    JOINT EXAMINATION
    EVIDENCE-BASED COUNSEL
    DEXA BONE-DENSITY REVIEW
    FAMILY CONSULTATION
    ANATOMY WALK-THROUGH

    Ready to feel better?

    Book a consultation with Dr. Avinash Punshi and take the first step toward lasting relief.
    Dr. Avinash Punshi
    Consultant Physician & Rheumatologist
    Compassionate, evidence-based rheumatology care across Karachi — helping patients live free of joint pain, longer.
    Quick Links

    OPD Timings

    • Doctor Ziauddin Hospital
      Clifton Campus, Block 2
      Mon · Wed · Fri·1:00 – 4:00 PM
      Fees Rs. 2,500
    • Ziauddin Hospital
      Kemari Branch
      Wednesday·12:00 – 2:00 PM
    • Ziauddin Hospital
      North Nazimabad, Block 2
      Tue · Thu · Sat·1:00 – 3:00 PM
      Fees Rs. 2,500
    • Rim Trauma Hospital
      PECHS Block 6, Shahrah-e-Faisal
      Tue · Thu · Sat·4:30 – 6:00 PM
      Fees Rs. 2,000
    • South City Hospital
      Shahrah-e-Firdousi, Clifton
      Tue · Thu·6:30 – 8:30 PM
      Fees Rs. 3,500
    • Islamabad Diagnostic Centre
      Rafiq Plaza, Lucky Star
      Mon · Wed · Fri · Sat·7:30 – 10:00 PM
      Fees Rs. 2,000
    • Islamabad Diagnostic Centre
      Rafiq Plaza, Lucky Star
      Tue · Thu·9:00 – 10:00 PM
      Fees Rs. 2,000
    Saturday appointments are subject to confirmation before your visit.

    Appointments: Mr. Vishal · +92 301 2399339

    © 2026 Dr. Avinash Punshi. All rights reserved.

    Consultant Physician & Rheumatologist · Karachi, Pakistan

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