Recognizing Rheumatoid Arthritis Symptoms

Rheumatoid arthritis is a serious illness but one that can be treated. Best results come when the disease is recognized early on and treated promptly and aggressively. Rheumatoid arthritis or RA is a chronic and systemic autoimmune disease characterized by inflammation that affects mainly the joints. However, other parts of the body are also susceptible to RA’s ravages with many patients also having problems with the heart, lungs, blood vessels, digestive system and skin. A few patients may show these symptoms even before joint involvement but most present with joint problems.

Patients with RA often complain of malaise, or a general sense of feeling unwell and uncomfortable. Of course this is not specific to RA and could be many other conditions but taken with other symptoms may raise suspicion for the diagnosis. Many patients also complain of extreme fatigue despite not doing any unusually strenuous activity.

Some patients will also have unexplained weight loss as part of the RA process. This can result both from the overall inflammation and from involvement of the digestive system. This is also a very general symptom.

Joint complaints are the single most common presenting symptom for RA. Most commonly more than one joint is involved and most often the joints on both sides of the body are reactive at the same time. Joints may be only tender to the touch or can be painful all or most of the time. Affected joints are also often warm to touch and may be visibly swollen. Later in the disease, joints become rigid and deformed. Fingers and toes may angle to one side severely and impair function profoundly.

Another common RA symptom is stiffness in joints upon awakening that lasts for a considerable time, usually more than one hour. Other forms of arthritis can cause stiffness, but usually this does not last as long and may be more noticeable after activity, not before becoming active and mobile.

When the disease has progressed, x-rays will show evidence of joint destruction and can track the progress of the illness, but early on no damage is immediately seen on films. Other imaging studies such as cat scans and MRI’s also can be used to assess the joints. Fluid can also be drawn from affected joints and those with RA will usually show a greatly elevated white blood cell count in this synovial fluid. Finding too many white cells without any bacteria is highly suspicious for RA.

Blood tests can also help to make the diagnosis. About 85% of people with RA will test positive for the rheumatoid factor or RF. Some people who test positive are not ill, but with the other symptoms this is usually quite diagnostic. In addition, other tests such as the C-reactive protein test (CRP) and the ESR or sedimentation rate will also be elevated in RA. Newer tests are finding even more specific markers that confirm RA as well. There are also genetic markers that are associated with an increased risk of RA.

Even small children may have RA but it is most common in people of about 30 to 50 years old and affects women three times as often as men. A family history of RA or related conditions is also not uncommon. Anyone who has symptoms suspicious for rheumatoid arthritis should be seen by a doctor, since the best outcome is found with early diagnosis and treatment.

Resources

Early symptoms of RA:
www.ra.com/ra/rastore/

About.com site on RA, common symptoms:
http://arthritis.about.com/b/2007/

Mayo Clinic information on RA symptoms:
www.mayoclinic.com/health/rheumatoid-arthritis

Arthritis Foundation website with list of symptoms on RA pages:
www.arthritis.org