Rheumatoid Arthritis Early Symptoms
Rheumatoid arthritis or “RA” is a serious chronic disease and it is important to diagnose it and begin treatment as early as possible. Unfortunately, it is not always easy to tell when a person has RA. The early signs and symptoms are common to many other illnesses and to other rheumatic and arthritic diseases as well. It is so important to begin treatment as soon as possible that anyone with some of the symptoms should seek medical care and mention their concern about rheumatoid arthritis.RA can affect the whole body so it is a mistake to believe that only the joints will be abnormal. Many people with RA also have involvement of the skin, respiratory system, heart, blood vessels and stomach. While these may become more obvious later in the course of the disease, they can also appear early on. Unexplained weight loss is one very general sign of RA and is one of the early indicators.
Of course swollen joints are an obvious sign of RA and usually the condition is symmetrical striking both sides of the body at once. The smaller joints such as finger and wrist bones are often struck first and the joints may be tender to the touch before heat, redness and swelling are noted. With advanced disease, the joints are more damaged and become slightly dislocated and deformity occurs. Occasionally, only one joint could be affected early on.
Morning stiffness is another hallmark of RA. Typically this will last at least thirty minutes but may last for several hours. Other forms of arthritis can also cause this symptom.
Some people will have symptoms similar to the flu, with malaise and low grade fevers and will also develop anemia and changes in the white blood cell count. Many other things cause these symptoms which may also include weight loss.
Blood work can be one of the most helpful tools for early diagnosis. In the past, tests for the rheumatoid factor (RF) were done, but about a third of RA patients may not have the RF factor present, especially early in the course of the illness, and others have it but do not have RA. CRP or C-reactive protein, and sedimentation rate or ESR are usually abnormal as well, but these are also not specific for RA. A new test called the anti-CCP or anti-cyclic citrullinated peptide antibody test is very promising. It is more specific for RA and can confirm the diagnosis.
X-rays, MRI’s and cat scans of affected joints can also be helpful, but may not show much in early cases. The goal is to treat effectively before damage has occurred.
Researchers in Holland came up with a scoring method to assess how likely having RA is from the signs and symptoms. This includes age and gender, since middle age and being female are higher risk. It also includes the presence of localized symptoms and morning stiffness, the count of tender joints and the count of swollen joints. It also uses three blood tests, the RF, the CRP and the anti-CCP tests. A high score makes the diagnosis of RA more precise so that early treatment can begin.
Rheumatoid arthritis is a disease that is poorly understood by many people. The perception is often that it is a uniformly crippling illness, but with modern treatment the prognosis is much more hopeful. The most important tools are early diagnosis and effective treatment. A nearly diagnosed patient with RA (rheumatoid arthritis) should be concerned but not terrified.
RA is an inflammatory arthritis and belongs to the class of autoimmune illnesses. In these, the body’s defensive immune system becomes misdirected and turns on its own tissues causing pain, swelling, and eventually permanent damage to joints and harm to other body systems. Treatment is designed to stop inflammation and prevent damage from ever occurring.
Early symptoms of RA can mimic many other illnesses and may not even involve the joints at first. Some people feel as if they have the flu and will have fever, fatigue, body aches and weight loss. Others do present with red, swollen and painful or tender joints, usually starting in the smaller joints and happening on both sides of the body at the same time. But diagnosis is made based on symptoms as well as certain lab and other diagnostic tests.
Blood tests will normally include the rheumatoid factor (RF), the ESR, CRP and anti-CCP as well as blood chemistries and a complete blood count. X-rays and other imaging may be done to see if any joint damage is present. RA is most commonly diagnosed in the 30 to 50 age group but can occur at any age, even in some children. At present an estimated two million Americans are believed to have RA.
Treatment of RA is focuses on stopping the inflammation and at relieving distressing symptoms. RA affects the entire body and there may be problems with the blood vessels, heart, lungs, skin, eyes, muscles and digestive system as well. Treating the underlying inflammation usually helps with all of these problems. Careful monitoring is needed for RA patients because damage may continue unless the disease is in remission.
A combination of medications is normally used to treat RA. Treatment needs to be decisive since damage is permanent and prevention is preferred. Some medications may be given for pain relief, but treating the inflammation is the best way to relieve pain and tenderness. Anti-inflammatory drugs include NSAIDs like aspirin, ibuprofen and piroxicam as well as steroidal drugs like prednisone. Other medications called DMARDs, or disease modifying anti-rheumatic drugs, are very active against RA effects. Finally, the newest weapon against RA is the slow acting or biologic response modifying class of medications, usually given as shots or IV infusions.
About 90 per cent of RA patients get excellent control of their disease and can often avoid disability. With ongoing research and physical therapy and even surgery, the problems of even those with hard to treat RA can be helped to lead more normal lives. It is important to get early and correct diagnosis, treat aggressively, and to get support from friends, family and organizations to win the war with rheumatoid arthritis. Education makes the whole process easier for all involved.
Resources
About.com arthritis site information about the risk of symptoms being RA:
http://arthritis.about.com/b/2007/02/01/early-rheumatoid-arthritis-symptoms-predicting-the-risk.htm
Need for early diagnosis of RA and how to recognize it:
www.ra.com/ra/rastore/cgi-bin/ProdSubEV_Cat_200148_SubCat_200148_NavRoot_301.htm
Mayo Clinic information on RA diagnosis:
www.mayoclinic.com/health/rheumatoid-arthritis/DS00020/DSECTION=2
Help for RA patients old and new:
http://www.arthritissupport.com/supportgroups/
Comprehensive about.com site on arthritis:
arthritis.about.com/od/rheumatoidarthritis/
RA as a systemic illness:
arthritisinsight.com/medical/disease/ra/notjustthejoints.html
American College of Rheumatology fact sheet on RA:
www.rheumatology.org/public/factsheets/ra_new.asp