Signs of Rheumatoid Arthritis in Adults and Young People

Rheumatoid arthritis is a long-term disease that causes pain, swelling, and stiffness in the joints, most often in the hands, feet, and wrists. It is an autoimmune condition: the immune system mistakenly attacks the tissue lining the joints. Below is what helps recognize the disease at an early stage, when treatment is especially effective.

How rheumatoid arthritis begins

According to recommendations, the first changes in the immune system may occur years before noticeable symptoms. The disease develops over time, and at the beginning there may be few symptoms. The first manifestations sometimes occur after heavy physical exertion, emotional shock, overwork, during hormonal changes, or after an infection. Rheumatoid arthritis can occur at any age, but the risk increases with age; the average age of onset is 40–50 years in women and somewhat higher in men. Women are affected 3–5 times more often.

Signs of joint inflammation

Joint involvement in rheumatoid arthritis has characteristic features. Pain and stiffness with movement worsen in the morning or after immobility. The joint becomes painful, red, and warm; swelling makes it difficult to comb one's hair, fasten clothing, or bend the knees. Symmetry is typical: if one hand or knee is affected, the other side is affected too. Over time, inflammation damages cartilage and adjacent bone.

Which joints are affected and whether the back hurts

The small joints of the hands, feet, and wrists are most often involved. These are the ones to look at first. Among the typical areas named are the hands, feet, and wrists; there is no information on back pain as a sign of rheumatoid arthritis — its cause is determined by a doctor. Dense nodules sometimes appear under the skin near the joints.

Pain syndrome and morning stiffness

Pain in rheumatoid arthritis is associated with inflammation, and symptoms either worsen (flare-ups) or subside. Flare-ups are difficult to predict, but with treatment their number decreases, and the duration of remission reaches months and even years. Pain and stiffness are usually worse in the morning or after immobility.

Manifestations outside the joints in young and elderly people

The clinical manifestations of rheumatoid arthritis are not limited to the joints. There may be fatigue, fever, and loss of appetite. Inflammation can affect the eyes, skin, heart, nerves, blood, and lungs; carpal tunnel syndrome is possible, and the risk of heart attack and stroke is increased.

• symmetric pain and swelling of the small joints of the hands and feet
• morning stiffness that worsens after rest
• redness and a feeling of warmth in the joint
• fatigue, fever, loss of appetite
• dense nodules under the skin near the joints

When to see a doctor

You should see a doctor if symptoms similar to rheumatoid arthritis appear: early diagnosis allows treatment to begin and reduces the risk of joint damage. The doctor will ask about the medical history and family history, examine the joints, look for rash and nodules, and listen to the chest. There is no single test: the disease develops gradually, and there are few symptoms at the onset. Blood tests are used (ESR, C-reactive protein, rheumatoid factor, antibodies to cyclic citrullinated peptide), synovial fluid analysis, X-ray, and ultrasound to rule out other causes. If necessary, the patient is referred to a rheumatologist.

This disease by itself is not a reason to call an ambulance; 103 or 112 — if there are signs of stroke or heart attack.

Ask your doctor: which joints are affected and whether this is symmetric, what examinations are needed, how to distinguish a flare-up from other causes of pain, and which extra-articular manifestations to monitor. This 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