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| Arthritis |  |
Rheumatoid Arthritis
Symptoms and Diagnosis
The onset of RA is usually gradual, but occasionally it is quite abrupt.
Symptoms
Early in the course of the illness, even before the joints are involved, the person experiences
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Fatigue and weakness |
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General feeling of malaise (feeling ill) |
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Low-grade fever |
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Inflammation of the eyes |
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Loss of appetite |
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Weight loss. |
Joint symptoms include:
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Pain, swelling, and red/purple color of joints of the fingers (but not usually the joints closest to the fingertips), wrists, ankles, and toes. Several joints are usually involved in the onset. Occurs symmetrically on both sides of the body (osteoarthritis does not present symmetrically) |
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Warm and tender joints |
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Stiffness, usually early morning, improves during the day |
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Red, painless skin lumps called rheumatoid nodules, over the affected joints |
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Bent and gnarled deformities (usually in fingers and hands) in long-term RA |
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Appearance of painful, swollen joints |
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Initial involvement is usually confined to one or a few joints. Involved joints will characteristically be quite warm, tender and swollen. |
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As the disease progresses joint deformities will manifest in the hands and feet. (These deformities are usually called by names such as swan neck, boutonniere and cockup toes.) |
The disease can occur in many forms, from a mild short-term illness with little damage in only a few joints to a severe progressive condition with significant destruction of many joints. Most people are somewhere between these two extremes.
Clinical Manifestations
A variety of abnormal laboratory findings are seen generally in RA. These include: elevated erythrocyte sedimentation rate characteristic of inflammatory conditions, anemia, serum protein abnormalities and antibodies to altered immunoglobulins.
Examination of the joint fluid usually reflects the degree of inflammation.
X-rays usually show soft tissue swelling, erosion of cartilage and joint space narrowing.
Next Topic: Conventional Medical Treatment
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