Signs and Symptoms of Rheumatoid Arthritis
Part of the process of understanding RA or rheumatoid arthritis is
learning how to recognize it. It is important to seek help
immediately if you suspect you or a loved one might have RA since
early treatment can prevent disability in most cases.
We talk about the signs and symptoms of rheumatoid arthritis and it helps to understand the difference. A sign is something that can actually be seen or observed in some way or something that can be measured. The pulse, temperature and blood pressure are examples of signs and in fact are part of what is called the vital signs. In RA, signs would be lab tests with specific values and such things as x-ray evidence of rheumatoid joint damage, visible swelling or redness.
Symptoms are perceived by the patient but not measurable. Examples of symptoms would be pain, tenderness, stiffness, fatigue, or aches. They are as real as signs but cannot be seen or quantified easily. An effort has been made to measure pain using scales from one to five or one to ten to make it more of a sign than a symptom. Ra presents with characteristic signs and symptoms.
While the signs and symptoms of RA may appear suddenly, usually they appear gradually over time. Common ones are fatigue, loss of appetite and weight loss, low grade fevers, morning stiffness, and red and swollen joints. Pain and aches are also common and joints may feel warm to the touch. On imaging, there will be excess synovial fluid inside a joint where the synovium is inflamed. As inflammation increases, the synovium becomes thicker and gradually erodes cartilage and bone. Usually in RA the involvement of joints is symmetrical and both sides flare up at once.
An unusual sign of RA is hoarseness or a change in the voice. This happens because the joint that controls the vocal cords of the larynx (voice box) is inflamed. This is called the cricoarytenoid joint. Involvement of the TMJ may produce the symptom of pain and difficulty speaking and in eating.
RA does not only affect the joints, so other body systems may show abnormalities that point to a diagnosis. Skin nodules or bumps called rheumatoid nodules near pressure points are one example. Lung involvement can also occur and the rheumatoid nodules can also appear in the lungs. Heart disease and gastritis are other manifestations of RA in the organs of the body. One serious symptom is vasculitis, or inflammation of the blood vessels. This is potentially life and limb threatening when present in RA. Like all the symptoms, controlling the inflammation is critical to treatment.
Certain tests also are symptomatic of RA including anemia and changes in the white blood cell count. The RF or rheumatoid factor is elevated in 70% to 80% of RA patients and most also have an elevated ESR or “sed rate.” X-rays, CT scans and MRI’s can also show changes in joints that are characteristic of RA.
RA may be a disease that waxes and wanes and the same symptoms and
signs seen for diagnosis can signal a flare in the illness. Like
early diagnosis, recognizing flares can mean prompt treatment and
reduces the chances of complications and permanent damage. Anyone
who believes their signs and symptoms might be RA or an RA flare
needs to contact their physician promptly.
Resources
Great About.com arthritis site with tons of information on RA:
http://arthritis.about.com/
Comprehensive Mayo Clinic site for RA information: www.mayoclinic.com/
Information on symptoms of RA and treatments: www.medicinenet.com/
Indolent nature of RA symptoms: www.webmd.com/