What are the early signs of rheumatoid arthritis? Rheumatoid arthritis is one of the more common forms of autoimmune arthritis, affecting about 1% of the adult population. This may not seem quite common, but in the world of rheumatology this is actually quite common. Women tend to be affected more than men 2-3:1 and the disease tend to manifest between the ages of 40 – 60. However, it can also happen in young adults and older individuals. When it happens in children, we call it juvenile idiopathic arthritis.
Early Signs of Rheumatoid Arthritis
The following are some of the early signs of rheumatoid arthritis.
#1 Inflammatory joint pain
Most of us experience joint pain at some point in our lives. This is simply a part of being human. However, most of us experience non-inflammatory joint pain NOT inflammatory joint pain. Non-inflammatory joint pain typically worsens as the day progresses. There typically is no swelling, redness, or warmth. There can be stiffness but typically this last just a few minutes and certainly less than 30 min. Basically, things quickly get better as you get going.
People that suffer from rheumatoid arthritis present with inflammatory joint pain, which presents very differently.
- Joint pain that is worse in the morning and improves as the day goes by.
- There is joint swelling and usually they feel warm. At times they can look red.
People suffering from rheumatoid arthritis experience stiffness that usually lasts more than one hour.
#2 Involvement of knuckles, wrists, ankles, and toes
Although rheumatoid arthritis certainly affects larger joints, like the knees, hips, and shoulders, it tends to affect smaller joints like the knuckles, wrists, ankles, and toes.
#3 Symmetrical joint distribution
This is pretty self-explanatory. Rheumatoid arthritis inflames joints symmetrically. If the second knuckle on the right hand is inflamed, the second knuckle on the left hand most likely will be too. Maybe not as much, but inflamed nonetheless. However, it’s important to take this with a grain of salt, particularly early in disease.
#4 Fatigue
People often feel very tired, when they suffer from rheumatoid arthritis. I’m talking can’t make it through the day tired.
#5 Fevers
This often depends on how quickly symptoms emerge. Symptoms of rheumatoid arthritis usually develop over the course of months (55 – 65% of cases), but at times can develop over a few weeks (15 – 20%), and even days (10%). The quicker the onset, the more likely someone will experience low grade fevers. Some people, particularly those aged greater than 65 years, can present like polymyalgia rheumatica. These people often present with fevers as well.
What Are Some Other Symptoms of Rheumatoid Arthritis?
Rheumatoid arthritis is a very complex autoimmune disease that can affect many different organs. We discussed the 5 common early signs of the disease but the following are some other less common manifestations.
Cardiac
- Pericarditis
- Myocarditis
- Coronary vasculitis
Dermatologic
- Nodules
- Skin vasculitis
Ocular
- Scleritis
- Episcleritis
- Retinal nodules
Pulmonary
- Pleuritis
- Interstitial lung disease
- Bronchiolitis obliterans
- Lung nodules
Neuromuscular
- Nerve entrapment – e.g., carpal tunnel syndrome
- Neuropathy
Other
- Severe dry eyes and dry mouth
- Felty’s syndrome
What Are Some Of The Mimickers Of Rheumatoid Arthritis?
When faced with symptoms that look and sound like rheumatoid arthritis, it’s important to take a step back and consider alternative diagnoses. Some of these include:
- Osteoarthritis
- Psoriatic arthritis
- Lupus
- Gout and pseudogout
- Polymyalgia rheumatica
- Lyme arthritis
- Sarcoidosis
- Hepatitis C
- Etc..
Next Steps
If you think you or one of your loved ones may be suffering from rheumatoid arthritis, I highly suggest you discuss your symptoms with your general practitioner or schedule as appointment with your local rheumatologist. Although, signs and symptoms are very important, a good history and physical examination in conjunction with specialized bloodwork and x-rays, are essential to either rule in rheumatoid arthritis and rule out other possibilities.
References
Rheumatology Secrets 3rd edition
Medical Disclaimer
This information is offered to educate the general public. The information posted on this website does not replace professional medical advice, but for general information purposes only. There is no Doctor – Patient relationship established. We strongly advised you to speak with your medical professional if you have questions concerning your symptoms, diagnosis and treatment.
