Rheumatoid Arthritis Symptoms
Rheumatoid arthritis symptoms mainly consist of pain and swelling in multiple joints.
Symptoms can be divided into three types
- General symptoms
- Articular (pertaining to joints) symptoms
- Extra-articular (apart from joint) symptoms
In majority (70%) of patients the disease begins as with General Symptoms that include
- loss of appetite
- vague muscle aches
These symptoms can last for many months before the actual appearance of joint pain and swelling.
Initial presentation of rheumatoid arthritis symptoms involving the joints is seen in nearly 30% of patients. These include
- movements of the joints are painful
- after a period of rest the joints feel stiff and this is usually seen as morning stiffness
- joint involvement is symmetrical
- joints usually involved include the following
joints of the back bone are spared except for the joints of the neck that may be involved
- proximal interphalangeal (middle joint of finger) joints
- metacarpo-phalangeal joint (knuckle joints)
- wrist joints
- elbow joints
- knee joints
- ankle joint
- joints of the foot
Gradually as the disease progresses various deformities and conditions develop that include
This photograph shows a Z deformity of the thumb in a patient of rheumatoid arthritis.
This photograph shows a hallux valgus or bunion deformity of the great toe.
Extra-articular rheumatoid arthritis symptoms are seen in about 40% of patients and they are more frequent in patients that have high levels of Rheumatoid Factor. They include
- Rheumatoid Nodules, that occur in 30% of patients of rheumatoid arthritis. They are more common near the joints and those areas that are subject to pressure such as the elbow, back of the ankle and back of the head. They themselves cause no symptoms, but they can be injured and can develop an infection.
- Respiratory system involvement is more common in males. There can be involvement of the lung tissue, blood vessels of the lung and the chest wall enclosing the lungs. Nodules can form and the lung can become stiff due to the deposition of fibrous tissue. Involvement of the joints of the vocal cords can occur along with nodule formation. This can cause difficulty in breathing.
- Blood vessels involvement can effect any organ of the body. Commonly involved are the blood vessels of the nervous system and skin. Less commonly the blood vessels of the bowel, spleen, pancreas, lungs, lymph nodes, liver and testes. Inflammation of the vessels causes obliteration of blood supply. This can produce a variety of symptoms. These are usually sensory loss, muscle paralysis, ulcers and gangrene of the skin. Rarely heart blood vessels are involved leading to a heart attack.
- Involvement of the eye is seen in less than 1% patients. The white of the eye becomes inflamed and there may be drying up of tears.
- Felty's syndrome is a condition seen in patients who have had rheumatoid arthritis for a long time. In these patients the spleen is enlarged, white blood cells are reduced and anemia may be present. Due to the reduced number of white cells these people are more susceptible to infections.
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This page was last updated on 31st March 2009.
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