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What
Are the Symptoms of Rheumatoid Arthritis ?
The
hallmark symptom of rheumatoid arthritis is morning stiffness that lasts
for at least an hour. (Stiffness from osteoarthritis, for instance,
usually clears up within half an hour.) Even after remaining motionless
for a few moments, the body can stiffen; movement becomes easier again
after loosening up. Symptoms such as fatigue, weight loss, and fever may
accompany early rheumatoid arthritis. Some people describe them as being
similar to those of a cold or flu, except, of course, RA symptoms can
last for years. Swelling and pain in the joints must occur for at last
six weeks before a diagnosis of rheumatoid arthritis is considered.
Although rheumatoid arthritis almost always develops in the wrists and
knuckles, the knees and joints of the ball of the foot are often
affected as well. Indeed, many joints may be involved. The pain often
occurs symmetrically but may be more severe on one side of the body,
depending on which hand the person uses more often. It does not usually
show up in the finger tips, where osteoarthritis is common, but joints
at the base of the fingers are often painful. The inflamed joints are
usually swollen and often feel warm and "boggy" when touched.
In
about 20% of people with RA, inflammation of small blood vessels can
cause nodules, or lumps, under the skin. They are about the size of a
pea or slightly larger, and are often located near the elbow, although
they can show up anywhere. Nodules can occur throughout the course of
the disease; they are usually painless, but rarely they can reflect the
presence of rheumatoid vasculitis, a condition that can affect blood
vessels in the lungs, kidneys, or other organs. Rarely, nodules may
become sore and infected, particularly if they are in locations where
stress occurs, such as ankles.
Fluid
may accumulate, particularly in the ankles. In rare cases, the joint sac
behind the knee accumulates fluid and forms what is known as a Baker
cyst; it feels like a tumor and sometimes extends down the back of the
calf causing pain.
In
children, juvenile rheumatoid arthritis, also known as Still's disease,
is usually preceded by high fever and shaking chills along with pain and
swelling in many joints. A pink skin rash may be present and internal
organs, such as the lungs and heart, may be involved.
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