Rheumatism of the Legs and Arms: Signs of Joint Involvement

In everyday language, the word "rheumatism" means almost any joint pain — in the knees, feet, or fingers. In medicine, its meaning is narrower, and the accuracy of the wording determines whom to see and what to examine. Below are the signs of joint involvement in the legs and arms and the boundary between rheumatism and rheumatoid arthritis.

What is called joint rheumatism

In medical literature, the term "rheumatism" has been replaced by the concept of "acute rheumatic fever" — a systemic inflammatory disease of connective tissue with predominant involvement of the heart membranes. It develops after an infection caused by group A β-hemolytic streptococcus: tonsillitis, chronic pharyngitis or tonsillitis, or scarlet fever. Symptoms appear 1–3 weeks after an acute streptococcal infection.

In other countries, this word describes lesions of periarticular soft tissues, and in everyday life it refers to musculoskeletal diseases in general. A separate story is rheumatoid arthritis: an autoimmune disease in which the immune system mistakenly attacks the cells lining the joints, most often of the hands, feet, and wrists. Rheumatoid arthritis affects the joint lining, cartilage, and adjacent bone; symptoms are similar to other types of arthritis, so the doctor orders blood tests and imaging to rule out other causes.

Rheumatism of the legs and knees: signs

The joint form of acute rheumatic fever — rheumatic polyarthritis — primarily affects large joints: knees, elbows, ankles. Pain occurs in the joints of the feet, knees, as well as shoulders, elbows, and hands; involvement is symmetrical, and the course is benign — no deformity remains after the attack.

In rheumatoid arthritis, the picture is different: pain and stiffness are worse in the morning or after immobility, the joint is swollen, hot, and tender to touch. Swelling makes daily activities difficult — for example, bending the knees.

Rheumatism of the hands and fingers: how it manifests

In rheumatoid arthritis, the hands and fingers are the most common site of involvement along with the wrist. Small joints hurt and swell symmetrically: if one hand is affected, so is the other. Stiffness makes it difficult to comb hair, button clothes, or hold small objects; dense painless nodules appear under the skin near the joints.

Rheumatism of the hands in rheumatic polyarthritis causes pain in the hands and elbows — symmetrical and with a rapid response to anti-inflammatory therapy.

Arthritis in rheumatism: what happens in the joint

Arthritis is inflammation of a joint, and its signs are similar regardless of the cause: pain, swelling, redness, a feeling of warmth, tenderness. In rheumatoid arthritis, the immune system attacks the joint lining: the joint becomes swollen, stiff, and painful, and over time the joint, cartilage, and adjacent bone are damaged. Inflammation can affect the eyes, skin, heart, nerves, blood, and lungs, and fatigue, fever, and weight loss sometimes come to the fore.

How rheumatism differs from other joint diseases

Rheumatoid arthritis differs from osteoarthritis, which often comes with age: in the former, the joint lining suffers and the tissue covering the ends of the bones is damaged. Acute rheumatic fever leaves the joint intact — no deformity remains, whereas rheumatoid arthritis without control can destroy joints. Symptoms of rheumatoid arthritis are similar to other types of arthritis, so the diagnosis is confirmed by a combination of examination, blood tests, and imaging; there is no single test.

What examinations are needed and when to see a doctor

The diagnosis is based on history and examination: the doctor clarifies the history of symptoms and family history, examines the joints, looks for rash and nodules, and listens to the chest. Then orders blood tests and imaging to rule out other causes of pain.

• blood tests, including ESR;
• rheumatoid factor and anti-citrullinated peptide antibodies;
• antinuclear antibodies and C-reactive protein;
• X-ray or ultrasound of the joints;
• synovial fluid analysis.

In acute rheumatic fever, increased ESR reflects inflammation activity; ECG and phonocardiography are used additionally. If arthritis is suspected, the therapist refers to a rheumatologist.

Joint involvement alone is not a reason to call an ambulance; 103/112 — for signs of stroke or heart attack and other life-threatening conditions.

The material is for reference and does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer