Symptoms of Rheumatoid Arthritis
RA or rheumatoid arthritis is a serious autoimmune inflammatory condition that is systemic in nature. RA can involve any part of the body but the hallmark symptom is usually joint problems. Such symptoms are usually Polyarticular, meaning more than one joint is involved at a time, and the joints are usually symmetrically affected as well.
Pain may be present or the joints at first may only be tender to the touch. Pain and tenderness are the result of the inflammatory process and inflammation also produces redness in many cases. In addition, swelling of the joints may also be noted.
Another common symptom of RA is morning stiffness. The joints do not want to bend and straighten easily and the stiffness lasts for awhile, at least an hour or longer. With other arthritis, especially osteoarthritis, there may be some stiffness on awakening but it usually disappears in a few minutes. The longer stiffness lasts, the more likely it is RA.
People who are diagnosed with RA often have a general feeling of being unwell, which is called malaise. This is nonspecific, but meaningful when combined with the other symptoms and signs of RA. Another common complaint is fatigue and a general lack of energy.
A visible sign of RA is the presence of firm nodules or knots under the skin, usually near joints. These are called rheumatoid nodules and are a strong clue to the disease being present.
While more common later on, symptoms of lung involvement make occur at diagnosis and rheumatoid nodules can appear in the chest cavity. Another symptom is stomach pain and digestive disturbances
Laboratory tests will also reveal symptoms of RA. One is a test for white blood cells in synovial fluid or leukocytosis. When this is present, the white cell count in the joint fluid will be greater than 2000 cells per cubic mm. Another lab test that can be extremely helpful is the RF test of the blood. RF stands for the rheumatoid factor and will be positive in about 85% of patients who have RA. (Those who definitely have RA but do not test positive for the RF are called seronegative RA patients.) There are some false positives for this test as well, or in other words, people who have the RF but who are not ill.
Another lab test for RA and other autoimmune diseases is the ESR or “sed rate” test. This determines how fast red blood cells settle out of anticoagulated whole blood and is elevated with inflammation of any kind. It is nonspecific but adds to the other symptoms to target a diagnosis of RA. Other markers in the blood are also tested and may be used to narrow a differential diagnosis down to one of rheumatoid arthritis rather than some other condition.
X-rays and other imaging tests such as scans and MRI’s can show changes in the joints associated with RA as well. Early in the disease swelling of the synovial membrane is seen, and later this encroaches into the joint space and eventually erodes cartilage and bone. Late in the illness, obvious and characteristic deformity of joints can be seen with the naked eye.
Clinical history as well as lab and imaging tests together form the signs and symptoms to make a diagnosis of confirmed RA. Anyone who has some of these symptoms should seek medical help and diagnosis. Early diagnosis leads to early treatment, and this produces the best results and can prevent permanent damage.
Resources
Early symptoms of RA: www.ra.com/ra/rastore/
Risk factors and RA symptoms: arthritis.about.com/
Mayo Clinic site about RA symptoms and treatment:
www.mayoclinic.com/health/rheumatoid-arthritis/
Early and late symptoms of RA:
www.webmd.com/rheumatoid-arthritis/
American College of Rheumatology factsheet on RA diagnosis:
www.rheumatology.org/public/factsheets/ra_new.asp