A Surprisingly Common Intractable Disease—Why Rheumatoid Arthritis Affects So Many Women
On May 23, 2025, the Setagaya Rheumatology & Collagen-Disease Clinic (Shinjuku Main Branch) hosted the seminar “A Surprisingly Common Intractable Disease—Rheumatoid Arthritis in Women (Vol. 1)”.
Key topics covered
- What exactly is rheumatoid arthritis?
- Spotting symptoms early—key points for detection
- Dramatic advances in RA treatment
- Joint pain related to menopause, aging, and other collagen diseases
What Is Rheumatoid Arthritis?—An Auto-Immune Inflammatory Disease
Rheumatoid arthritis (RA) is triggered by an autoimmune malfunction that inflames the synovial lining of joints. Left untreated, cartilage and bone are destroyed, causing joint deformity, intense pain, and limited range of motion.
Early-stage symptoms
- Stiffness or swelling in the small joints of the hands and feet
- Symmetrical joint pain (left–right)
Systemic symptoms
- Fatigue, low-grade fever
- Anemia, loss of appetite
If the disease progresses
- Deformities of the fingers
- Difficulty performing everyday tasks
Historical note: Descriptions consistent with RA appear as early as the 8th-century chronicle Zoku Nihon Ki.
Quick Symptom Checklist
Seek medical advice promptly if you notice
- Morning joint stiffness
- Symmetrical pain in hands or feet
- Swelling or warmth in joints
- Symptoms in multiple joints
- Persistent fatigue or low-grade fever
How Common Is RA, and Who Gets It?
- Prevalence in Japan: 0.6 – 1 % (≈ 700,000 – 800,000 people)
- Gender ratio: Women ≈ 4 × more likely than men
- Peak onset in women: Late-40s to 50s (around menopause)
Epidemiological risk factors
- Genetic: HLA-DR4 and related genes
- Environmental: Smoking, periodontal infection (P. gingivalis)
- Hormonal: Possible influence of estrogen
RA Is One of the Collagen Diseases
Collagen diseases are autoimmune disorders that inflame connective tissue throughout the body. Besides RA, major examples include
- Systemic lupus erythematosus (SLE)
- Systemic sclerosis (SSc)
- Polymyositis / dermatomyositis (PM/DM)
- Sjögren’s syndrome (SS)
- Mixed connective-tissue disease (MCTD)
- Systemic vasculitides
Diagnosis & the Importance of Early Detection
Early diagnosis and treatment are critical; once bone erosion advances, remission becomes harder.
Key diagnostic criteria (ACR/EULAR 2010)
Synovitis pattern, serology, acute-phase reactants, symptom duration—score ≥ 6 points = RA
Main blood tests
- Anti-CCP antibody (specificity > 95 %)
- Rheumatoid factor (RF)
- MMP-3
- Antinuclear antibody (ANA) for differential diagnosis
Other assessments
- Joint ultrasonography or MRI for synovitis/bone erosion
- Physical examination for tenderness and swelling
Clinical Expertise at Setagaya Rheumatology & Collagen-Disease Clinic
- Total RA patients treated: 3,010
- Shinjuku Main Branch: 1,190
- Toshin Yoshida Internal & Rheumatology Clinic (Nagano): 1,043
- Soshigaya Branch: 373
- Kokubunji Rheumatology Clinic: 404
- SLE patients: 575
- International patients from: Hong Kong, Taiwan, mainland China, Switzerland, the UK, USA, Peru, Hawaii, and more—evidence of globally trusted care.
Worried You Might Have RA?—Easy Self-Screening Tool
Use our free online “Setagaya Rheumatology Quick Check” to gauge your risk and decide whether to seek a specialist consultation early.
If You Suspect RA, Don’t Delay
Persistent joint pain, stiffness, or systemic discomfort should never be ignored. Early intervention greatly increases the chance of achieving remission—a state where disease activity is minimal.
About the Author
Tomohiko Yoshida, MD, PhD
Medical Director, Toshinkai Medical Corp. / Setagaya Rheumatology & Collagen-Disease Clinics
- Board-certified in Internal Medicine and Rheumatology
- Rheumatology instructor, industrial physician, disability certification examiner
- Specialties: RA, collagen-disease management during pregnancy, systemic autoimmune disorders