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Arthritis – Rheumatoid

Symptoms And Affected Tissues

The prominent feature of rheumatoid arthritis is joint inflammation. Affected joints are usually swollen, warm, painful and stiff. These symptoms typically worsen in the morning but, at least early in the disease process, can sometimes be eased by gentle movement. As the disease progresses, however, these symptoms often increase in severity until movement is severely impaired.

Inflammation associated with RA is systemic, meaning that it is not isolated to only those joints affected. RA tends to present symptoms in a symmetrical way. For example, if the joints of the right hand are inflamed, the joints of the left hand are likely to be inflamed as well (St. Clair 2004). While the hand and wrist joints are most often affected, other joints may be involved including those of the feet and ankles, knees, hips, elbows, shoulders, and the cervical spine (i.e., the neck) (Klippel 2010).

In general, the symptoms and severity of RA follow one of three patterns (Ruffing 2012):

  • Spontaneous remission: The symptoms ultimately disappear, which occurs in less than 10% of patients with RA. This generally occurs only in patients whose blood tests are negative for a protein called rheumatoid factor (RF), an autoimmune mediator.
  • Relapsing/remitting disease: The patient experiences periods of very severe symptoms called "flares", which are contrasted with episodes of mild or no symptoms. This pattern generally occurs early on in the course of the disease.
  • Persistent and progressive disease: Disease activity gets progressively worse. However, flares and periods of remission are not as dramatic as relapsing/remitting disease. This is the most common course of disease.

During the course of the disease process, RA mediated inflammation can cause permanent damage to several tissues in the body, especially the joints (NIAMS 2009).