Rheumatoid Arthritis


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The hallmarks of Rheumatoid Arthritis (RA) are swelling, stiffness, pain and loss of function in the joints.  These symptoms are caused by inflammation of the affected areas by the body’s immune system.  The most commonly affected joints are in the fingers and wrists, but almost any joint can be involved.  Symptoms that often differentiate RA from other types of Arthritis are a symmetrical pattern of affliction, fever and fatigue. Individual experiences with RA vary considerably.  In addition to variable joint involvement, the duration of the disease may be a only few months or last a lifetime, the severity may be mild or severe and the disease may leave the integrity of the joint intact or cause debilitating damage.

Rheumatoid Arthritis Symptoms

·        Swollen Joints, often tender and warm to the touch.

·        Inflammation of the wrist and fingers.

·        Joints affected in a Symmetrical fashion.  (Both Hands, feet and wrists instead of affecting only one side)

·        Fever, fatigue and general malaise.

·        Morning pain and stiffness

·        Inflammation of joints other than hands.  (shoulders, elbows, ankles, feet, hips and neck)

·        Individual symptom variability


The autoimmune component of RA can manifest as fever, malaise, rash, fatigue, lymphadenopathy, splenomegaly, vasculitis, anemia, pulmonary nodules, pleural effusions, pericarditis, Sjogren’s syndrome and/or scleritis . Any organ system can be affected by the underlying disease process of RA resulting in a long list of signs and symptoms related to the condition.

Other obvious clinical observations would involve the musculoskeletal system’s presentation of warm joints, erythema, swelling, joint deformity, “boggy” synovial membrane upon palpation and decreased ability to adequately complete range of motion (ROM) exercises  .  With hematologic system involvement, anemia related symptoms may be present: easy bruising, pallor, pale oral mucosa and splenomegaly.  Integumentary system involvement would present with skin rash or as skin with a ruddy, cyanotic hue that seems thin and shiny around the affected joints. Nodules in the subcutaneous tissue can form near elbows and fingers, or less commonly on the scalp, back, feet, hands, buttocks, and knees .  Cardiovascular system involvement can be detected upon examination. Possible findings include abnormal heart sounds indicative of valve deformities or a pericardial friction rub indicative of pericarditis . Inspection and palpation could detect vascular insufficiency related to Raynaud phenomenon. Other potential symptoms might include dry eyes and mucous membranes.


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