Signs of Rheumatoid Arthritis

Signs of rheumatoid arthritis come and go, as per the amount of tissue inflammation. When the tissues are inflamed, the disease is manifested actively. When the inflammation subsides, there is inactivity in the manifestation. This is called remission of symptoms. Remissions are spontaneous or may occur with treatment and can last for weeks, months or even years. During this period, symptoms vanish totally. But with the relapse of the disease, they return back. This stage is called a flare. Periods of flares and remissions vary from patient to patient.

Signs of rheumatoid arthritis, when the disease is in active stage, are fatigue, energy-loss, appetite-loss, mild fever, muscle and joint pain, and stiffness. Stiffness in the muscles and joints is predominant in the morning and after a period of inactivity. Commonly during the flares, joints become red, painful, swollen and tender. This is because of the inflammation of synovium, i.e. the lining of the joints, which results into excessive production of synovial fluid. There is also thickening of joints, along with inflammation. In children, signs of rheumatoid arthritis are limping, crying, irritability and impaired appetite.

RA generally affects multiple joints in symmetrical pattern, i.e. same joints of body’s both sides are affected. Early signs may be minor. Often small joints of both hands and wrists are affected. If hands are involved, symptoms, like difficulty in simple daily activities, are seen. This is true about the small joints of feet too, resultants of which are pain while walking, particularly early in the morning after waking up.

Rarely only one joint is affected and then signs of rheumatoid arthritis are like those of gout or joint infection. Chronic inflammation can damage body tissues, like cartilage and bone. This results in loss of cartilage and erosion and weakening of bones and muscles, which ultimately leads to joint deformity, damage and function-loss.

Rarely RA occurs in the joint of our vocal cord, i.e. cricoarytenoid joint. This results in hoarseness of voice.

As this is a systemic disease, its inflammation can include organs other than joints. When glands of mouth and eyes are involved, these organs become dry. This condition is called Sjogren’s syndrome. Corneal abrasion can occur due to drying of eyes. Inflammation of the white part of the eye, i.e. scleritis, is very dangerous for the eye.

When lung lining is inflamed, it is called pleuritis and it gives chest pain while deep breathing, shortness of breath, or coughing. The lung tissue itself too can be inflamed and scarred, and sometimes rheumatoid nodules develop in the lungs.

Signs of Rheumatoid Arhthritis

When pericardium, i.e. lining of the heart is inflamed, it is called pericarditis, and it causes chest pain too. This pain is more intense while lying down and leaning forward.

Reduction in RBCs, i.e. anemia, as well as in WBCs, can occur due to RA. With the reduction of WBCs, chances of infection are increased. It is associated with enlarged spleen too, which is called Felty’s syndrome.

Rheumatoid nodules are seen under the skin of elbows and fingers too, where they are often pressurized. Though they don’t cause symptoms, sometimes they may get infected.

Other signs of rheumatoid arthritis include carpal tunnel syndrome, in which nerves of wrists are pinched, and vasuclitis, i.e. inflammation of blood vessels. Vasculitis can hamper blood supply to tissues and thus can lead to cell death, i.e. necrosis. This is seen from tiny black patches around nail beds or leg ulcers.