Rheumatoid Arthritis (cont.)
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Catherine Burt Driver, MD
Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.
In this Article
- Rheumatoid arthritis (RA) facts
- What is rheumatoid arthritis (RA)?
- What are causes and risk factors of rheumatoid arthritis?
- What are complications of rheumatoid arthritis?
- What are rheumatoid arthritis symptoms and signs?
- What tests do physicians use to diagnose rheumatoid arthritis?
- What is the treatment for rheumatoid arthritis? What types of medications treat RA?
- "First-line" rheumatoid arthritis medications
- "Second-line" or "slow-acting" rheumatoid arthritis drugs (disease-modifying anti-rheumatic drugs or DMARDs)
- What are newer rheumatoid arthritis treatments?
- Rheumatoid arthritis diet, exercise, home remedies, and alternative medicine
- What about rheumatoid arthritis and pregnancy?
- What is the prognosis (outlook) for patients with rheumatoid arthritis?
- Is it possible to prevent rheumatoid arthritis?
- What specialists treat rheumatoid arthritis (RA)?
- What new information about RA has come from the 2015 national meeting of the American College of Rheumatology?
- What research is being done on rheumatoid arthritis?
- Where can people get additional information on rheumatoid arthritis?
- Rheumatoid Arthritis Slideshow
- Take the RA Quiz
- Rheumatoid Arthritis Exercises Slideshow
- Newly Diagnosed Rheumatoid Arthritis Treatment
- Rheumatoid Arthritis FAQs
- Find a local Rheumatologist in your town
What are rheumatoid arthritis symptoms and signs?
RA symptoms come and go, depending on the degree of tissue inflammation. When body tissues are inflamed, the disease is active. When tissue inflammation subsides, the disease is inactive (in remission). Remissions can occur spontaneously or with treatment and can last weeks, months, or years. During remissions, symptoms of the disease disappear, and people generally feel well. When the disease becomes active again (relapse), symptoms return. The return of disease activity and symptoms is called a flare. The course of rheumatoid arthritis varies among affected individuals, and periods of flares and remissions are typical.
When the disease is active, RA symptoms can include fatigue, loss of energy, lack of appetite, low-grade fever, muscle and joint aches, and stiffness. Muscle and joint stiffness are usually most notable in the morning and after periods of inactivity. This is referred to as morning stiffness and post-sedentary stiffness. Arthritis is common during disease flares. Also during flares, joints frequently become warm, red, swollen, painful, and tender. This occurs because the lining tissue of the joint (synovium) becomes inflamed, resulting in the production of excessive joint fluid (synovial fluid). The synovium also thickens with inflammation (synovitis).
Rheumatoid arthritis usually inflames multiple joints and affects both sides of the body. In its most common form, therefore, it is referred to as a symmetric polyarthritis. Early RA symptoms may be subtle. The small joints of both the hands and wrists are often involved. Early symptoms of rheumatoid arthritis can be pain and prolonged stiffness of joints, particularly in the morning. Symptoms in the hands with rheumatoid arthritis include difficulty with simple tasks of daily living, such as turning door knobs and opening jars. The small joints of the feet are also commonly involved, which can lead to painful walking, especially in the morning after arising from bed. Occasionally, only one joint is inflamed. When only one joint is involved, the arthritis can mimic the joint inflammation caused by other forms of arthritis, such as gout or joint infection. Chronic inflammation can cause damage to body tissues, including cartilage and bone. This leads to a loss of cartilage and erosion and weakness of the bones as well as the muscles, resulting in joint deformity, destruction, and loss of function. Rarely, rheumatoid arthritis can even affect the joint that is responsible for the tightening of our vocal cords to change the tone of our voice, the cricoarytenoid joint. When this joint is inflamed, it can cause hoarseness of the voice. Symptoms in children with rheumatoid arthritis include limping, irritability, crying, and poor appetite.
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