Symptoms of Rheumatoid arthritis

Symptoms of Rheumatoid arthritis: Introduction

At the onset of the disease, the symptoms of rheumatoid arthritis can be vague and develop slowly. They may not include the classic symptom of joint pain that people often associate with arthritis. These indistinct, early symptoms may include fatigue, loss of appetite, and weakness. Other early symptoms include muscle achiness throughout the body and stiffness that lasts more than one hour after rising in the morning. Ultimately, joint pain develops and can be accompanied by inflammation and swelling in the joints. Joint pain generally affects wrists, fingers, knees, feet, and ankles on both sides of the body. Joint destruction may develop within 1-2 years after the onset of the disease.

Other symptoms may include problems with the eyes, deformities in the hands and feet, fever, paleness, anemia, nodules under the skin, swollen glands, and redness and inflammation of the skin.

Because of the generalized inflammatory nature of rheumatoid arthritis, it can affect almost any organ in the body and lead to life threatening complications. These include rheumatoid vasculitis (inflammation of the blood vessels) which can lead to atherosclerosis, stroke, heart attack and other cardiac conditions, skin ulcerations and infections, bleeding stomach ulcers, and nerve problems that cause pain, numbness, or tingling. The eyes can also be affected and the cervical spine (bones in the neck) can become instable.

Symptoms of Rheumatoid arthritis

The list of signs and symptoms mentioned in various sources for Rheumatoid arthritis includes the 29 symptoms listed below:

• Joint pain
• Joint swelling
• Joint stiffness
• Morning joint stiffness
• Joint stiffness after inactivity
• Joint tenderness
• Warm joints
• Ankle arthritis
• Foot arthritis
• Finger arthritis
• Wrist arthritis
• Symmetrical joint pattern - both sides of the body afflicted.
• Morning stiffness
• Weight loss
• Fatigue
• Decreased appetite
• Occasional fever
• Bouts of mild fever
• Malaise
• Episodic flares with remissions
• Variable symptoms - different people experience different effects
• Skin bumps (rheumatoid nodules) - about 25% of cases get these
• Anemia
• Neck pain
• Dry eyes
• Dry mouth
• Tiredness
• Afternoon fatigue
• Afternoon malaise
• more information...»

Research symptoms & diagnosis of Rheumatoid arthritis:

• Overview -- Rheumatoid arthritis
• Diagnostic Tests for Rheumatoid arthritis
• Complications -- Rheumatoid arthritis
• Doctors & Specialists
• Misdiagnosis and Alternative Diagnoses
• Hidden Causes of Rheumatoid arthritis
• Other Causes -- causes of these or similar symptoms

Rheumatoid arthritis: Complications

Review medical complications possibly associated with Rheumatoid arthritis:

• Chronic joint pain
• Joint deformity
• Anemia
• Blood vessel inflammation
• Lung lining inflammation (see Lung symptoms)
• Heart sac inflammation (see Heart symptoms)
• Eye disease - particularly for Pauciarticular JRA
• more complications...»

Diagnostic Testing

Diagnostic testing of medical conditions related to Rheumatoid arthritis:

• Physical exam
• Rheumatoid factor blood test - an antibody test
• Erythrocyte sedimentation rate (ESR)
• CBC
• White blood cell count
• more tests...»

Research More About Rheumatoid arthritis

Do I have Rheumatoid arthritis?

• Rheumatoid arthritis: Introduction
• Rheumatoid arthritis: Diagnostic Testing to confirm diagnosis
• Alternative diagnoses and misdiagnosis for Rheumatoid arthritis
• Failure to Diagnose Rheumatoid arthritis
• How serious is it?
• Treatments for Rheumatoid arthritis
• More about Rheumatoid arthritis

Rheumatoid arthritis: Undiagnosed Conditions

Diseases that may be commonly undiagnosed in related medical areas:

• Chronic Major Diseases that are commonly Undiagnosed:
  • High Cholesterol -- Undiagnosed
  • Heart Disease -- Undiagnosed
  • Cancer -- Undiagnosed
  • Depression -- Undiagnosed
  • Type 2 Diabetes -- Undiagnosed
  • Type 1 Diabetes -- Undiagnosed
  • Hypertension -- Undiagnosed
  • Hemochromatosis -- Undiagnosed
  • Metabolic Syndrome -- Undiagnosed
• more undiagnosed conditions...»

Wrongly Diagnosed with Rheumatoid arthritis?

The list of other diseases or medical conditions that may be on the differential diagnosis list of alternative diagnoses for Rheumatoid arthritis includes:

• Joint trauma
• Arthritis
• Osteoarthritis
• Lupus
• Lyme disease
• more diagnoses...»

See the full list of 52 alternative diagnoses for Rheumatoid arthritis

Rheumatoid arthritis: Research Doctors & Specialists

• Bone, Joint and Orthopedic Specialists:
  • Orthopedic Surgery
  • Neuromusculoskeletal Medicine
  • Rheumatology (Arthritis / Joint Pain)
• Arthritis & Joint Health Specialists (Rheumatology):
  • Rheumatology (Joint Health)
  • Pediatric Rheumatology (Child Joint Health)
• Senior Health Specialists (Geriatrics):
  • Geriatric Medicine (Senior Health Specialist)
  • Geriatric Psychiatry (Senior Mental Health)
• more specialists...»

Research all specialists including ratings, affiliations, and sanctions.

More about symptoms of Rheumatoid arthritis:

More information about symptoms of Rheumatoid arthritis and related conditions:

• Other diseases with similar symptoms and common misdiagnoses
• Tests to determine if these are the symptoms of Rheumatoid arthritis
• Symptoms that may be caused by complications of Rheumatoid arthritis
• Underlying causes of Rheumatoid arthritis
• Associated conditions for Rheumatoid arthritis
• Risk factors for Rheumatoid arthritis

Other Possible Causes of these Symptoms

Click on any of the symptoms below to see a full list of other causes including diseases, medical conditions, toxins, drug interactions, or drug side effect causes of that symptom.

• Afternoon fatigue - see all causes of Fatigue
• Afternoon malaise - see all causes of Malaise
• Anemia - see all causes of Anemia
• Ankle arthritis - see all causes of Joint pain
• Bouts of mild fever - see all causes of Mild fever
• Decreased appetite - see all causes of Poor appetite
• Dry eyes - see all causes of Dry eye
• Dry mouth - see all causes of Dry mouth
• Episodic flares with remissions
• Fatigue - see all causes of Fatigue
• Finger arthritis - see all causes of Finger symptoms
• Foot arthritis - see all causes of Foot symptoms
• Joint pain - see all causes of Joint pain
• Joint stiffness - see all causes of Stiff joints
• Joint stiffness after inactivity - see all causes of Stiff joints
• Joint swelling - see all causes of Joint swelling
• Joint tenderness - see all causes of Joint tenderness
• Malaise - see all causes of Malaise
• Morning joint stiffness - see all causes of Stiff joints
• Morning stiffness - see all causes of Stiffness
• Neck pain - see all causes of Neck pain
• Occasional fever - see all causes of Fever
• Skin bumps (rheumatoid nodules) - see all causes of Skin bumps
• Symmetrical joint pattern - see all causes of Joint symptoms
• Tiredness - see all causes of Tiredness
• Variable symptoms
• Warm joints - see all causes of Joint symptoms
• Weight loss - see all causes of Weight loss
• Wrist arthritis - see all causes of Wrist symptoms

Medical Books Online about Rheumatoid arthritis

Medical Books Excerpts Excerpts of published medical book chapters related to Rheumatoid arthritis are available from published medical books for more detailed information about Rheumatoid arthritis.

Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.

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Symptoms of Rheumatoid arthritis: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the symptoms of Rheumatoid arthritis.

Osteoarthritis: Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))

The most common symptom of osteoarthritis is a deep, aching joint pain, particularly after exercise or weight bearing, usually relieved by rest. Other symptoms include stiffness in the morning and after exercise (relieved by rest), aching during changes in weather, “grating’’ of the joint during motion, altered gait contractures, and limited movement. These symptoms increase with poor posture, obesity, and stress to the affected joint.

Osteoarthritis of the interphalangeal joints produces irreversible joint changes and node formation. The nodes eventually become red, swollen, and tender, causing numbness and loss of dexterity. (See What happens in osteoarthritis, page 590.)

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Diseases (Eighth Edition), 2005

Psoriatic arthritis: Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))

Psoriatic lesions usually precede the arthritic component; however, after the full syndrome is established, joint and skin lesions recur simultaneously. Arthritis may involve one joint or several joints symmetrically. Spinal involvement occurs in some patients. Peripheral joint involvement is most common in the distal interphalangeal joints of the hands, which have a characteristic sausage-like appearance. Nail changes include pitting, transverse ridges, onycholysis, keratosis, yellowing, and destruction. The patient may experience general malaise, fever, and eye involvement.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Diseases (Eighth Edition), 2005

Rheumatoid arthritis: Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))

RA usually develops insidiously and initially produces nonspecific signs and symptoms, such as fatigue, malaise, anorexia, persistent low-grade fever, weight loss, lymphadenopathy, and vague articular symptoms. Later, more specific localized articular symptoms develop, commonly in the fingers at the proximal interphalangeal, metacarpophalangeal, and metatarsophalangeal joints. These symptoms usually occur bilaterally and symmetrically and may extend to the wrists, knees, elbows, and ankles. The affected joints stiffen after inactivity, especially upon rising in the morning. The fingers may assume a spindle shape from marked edema and joint congestion. The joints become tender and painful, at first only when the patient moves them, but eventually even at rest. They commonly feel hot to the touch. Ultimately, joint function is diminished.

Deformities are common if active disease continues. (See Joint deformities.)  Proximal interphalangeal joints may develop flexion deformities or become hyperextended. Metacarpophalangeal joints may swell dorsally, and volar subluxation and stretching of tendons may pull the fingers to the ulnar side (“ulnar drift”). The fingers may become fixed in a characteristic “swan’s neck” appearance, or “boutonnière” deformity. The hands appear foreshortened, the wrists boggy; carpal tunnel syndrome from synovial pressure on the median nerve causes tingling paresthesia in the fingers.

The most common extra-articular finding is the gradual appearance of rheumatoid nodules — subcutaneous, round or oval, nontender masses — usually on pressure areas such as the elbows. Vasculitis can lead to skin lesions, leg ulcers, and multiple systemic complications. Peripheral neuropathy may produce numbness or tingling in the feet or weakness and loss of sensation in the fingers. Stiff, weak, or painful muscles are common. Other common extra-articular effects include pericarditis, pulmonary nodules or fibrosis, pleuritis, scleritis, and episcleritis.

Another complication is destruction of the odontoid process, part of the second cervical vertebra. Rarely, cord compression may occur, particularly in patients with long-standing deforming disease. Upper motor neuron signs and symptoms, such as a positive Babinski’s sign and muscle weakness, may also develop.

RA can also cause temporomandibular joint disease, which impairs chewing and causes earaches. Other extra-articular findings may include infection, osteoporosis, myositis, cardiopulmonary lesions, lymphadenopathy, and peripheral neuritis.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Diseases (Eighth Edition), 2005

Juvenile rheumatoid arthritis: Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))

Signs and symptoms vary with the type of JRA. Affecting males and females almost equally, systemic JRA accounts for approximately 10% to 30% of cases. The affected children may have mild, transient arthritis or frank polyarthritis associated with fever and rash. Joint involvement may not be evident at first, but the child’s behavior may clearly suggest joint pain. Such a child may constantly want to sit in a flexed position, may not walk much, or may refuse to walk at all. Young children with JRA are noticeably irritable and listless.

Fever in systemic JRA occurs suddenly and spikes to 103° F (39.4° C) or higher once or twice daily, usually in the late afternoon, then rapidly returns to normal or subnormal. (This “sawtooth” or intermittent spiking fever pattern helps differentiate JRA from other inflammatory disorders.) When fever spikes, an evanescent rheumatoid rash commonly appears, consisting of small pale or salmon pink macules, usually on the trunk and proximal extremities and occasionally on the face, palms, and soles. Massaging or applying heat intensifies this rash. It’s usually most conspicuous where the skin has been rubbed or subjected to pressure such as the areas of skin covered by underclothing.

Other signs and symptoms of systemic JRA may include hepatosplenomegaly, lymphadenopathy, pleuritis, pericarditis, myocarditis, and nonspecific abdominal pain.

Polyarticular JRA accounts for about 40% of cases and is three times more common in females than in males; affected children may be seronegative or seropositive for rheumatoid factor (RF). It involves five or more joints and usually develops insidiously. Most commonly involved joints are the wrists, elbows, knees, ankles, and small joints of the hands and feet. Polyarticular JRA can also affect larger joints, including the temporomandibular joints, cervical spine, hips, and shoulders. These joints become swollen, tender, and stiff. Usually, the arthritis is symmetrical; it may be remittent or indolent. The patient may run a low-grade fever with daily peaks. Listlessness and weight loss can occur, possibly with lymphadenopathy and hepatosplenomegaly. Other signs of polyarticular JRA include subcutaneous nodules on the elbows or heels and noticeable developmental retardation.

Seropositive polyarticular JRA, the more severe type, usually occurs late in childhood and can cause destructive arthritis that mimics adult rheumatoid arthritis.

Pauciarticular JRA involves few joints (usually no more than four), typically affecting the knees and other large joints. This form accounts for 45% of cases and has major subtypes. The first, pauciarticular JRA with chronic iridocyclitis, most commonly strikes females younger than age 6 and involves the knees, elbows, ankles, or iris. Inflammation of the iris and ciliary body is commonly asymptomatic but may produce pain, redness, blurred vision, and photophobia.

The second subtype, pauciarticular JRA with sacroiliitis, usually strikes males (9:1) older than age 8, who tend to test positive for human leukocyte antigen (HLA)-B27. This subtype is characterized by lower extremity arthritis that produces hip, sacroiliac, heel, and foot pain as well as Achilles' tendinitis. These patients may later develop the sacroiliac and lumbar arthritis characteristic of ankylosing spondylitis. Some also experience acute iritis, but not as many as those with the first subtype.

The third subtype includes patients with joint involvement who are antinuclear antibody (ANA) and HLA-B27 negative and don’t develop iritis. These patients have a better prognosis than those with the first or second subtype.

Common to all types of JRA is joint stiffness in the morning or after periods of inactivity. Back pain and limited range  of motion is common. Growth disturbances may also occur, resulting in uneven length of arms or legs due to overgrowth or undergrowth adjacent to inflamed joints.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Diseases (Eighth Edition), 2005

Septic arthritis: Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))

Acute septic arthritis begins abruptly, causing intense pain, inflammation, and swelling of the affected joint and low-grade fever. It usually affects a single joint. It most commonly develops in the large joints but can strike any joint, including the spine and small peripheral joints. The hip is a frequent site in infants. Systemic signs of inflammation may not appear in some patients. Migratory polyarthritis sometimes precedes localization of the infection. If the bacteria invade the hip, pain may occur in the groin, upper thigh, or buttock or may be referred to the knee.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Diseases (Eighth Edition), 2005

Hypothyroidism in adults: Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))

Typically, the early clinical features of hypothyroidism are vague: fatigue, menstrual changes, hypercholesterolemia, forgetfulness, sensitivity to cold, unexplained weight gain, and constipation. As the disorder progresses, characteristic myxedematous signs and symptoms appear: decreasing mental stability; dry, flaky, inelastic skin; puffy face, hands, and feet; hoarseness; periorbital edema; upper eyelid droop; dry, sparse hair; and thick, brittle nails. (See Facial signs of myxedema.)

Cardiovascular involvement leads to decreased cardiac output, slow pulse rate, signs of poor peripheral circulation and, occasionally, an enlarged heart. Other common effects include anorexia, abdominal distention, menorrhagia, decreased libido, infertility, ataxia, intention tremor, and nystagmus. Reflexes show delayed relaxation time (especially in the Achilles tendon).

Alert  Progression to myxedema coma is usually gradual but when stress (such as hip fracture, infection, or myocardial infarction) aggravates severe or prolonged hypothyroidism, coma may develop abruptly. Clinical effects include progressive stupor, hypoventilation, hypoglycemia, hyponatremia, hypotension, and hypothermia.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Diseases (Eighth Edition), 2005

Osteoarthritis: Signs and symptoms
(Handbook of Diseases)

The most common symptom of osteoarthritis is a deep, aching joint pain, particularly after exercise or weight bearing, usually relieved by rest. Other symptoms include:

❑  stiffness in the morning and after exercise (relieved by rest)

❑  aching during changes in weather (joint pain in rainy weather)

❑  “grating” of the joint during motion

❑  altered gait contractures

❑  limited movement.

These symptoms increase with poor posture, obesity, and occupational stress.

Osteoarthritis of the interphalangeal joints produces irreversible changes in the distal joints (Heberden’s nodes) and proximal joints (Bouchard’s nodes). These nodes may be painless at first but eventually become red, swollen, and tender, causing numbness and loss of dexterity. (See Viewing osteoarthritis.)

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Diseases, 2003

Psoriatic arthritis: Signs and symptoms
(Handbook of Diseases)

Psoriatic lesions usually precede the arthritic component; however, when the full syndrome is established, joint and skin lesions may recur simultaneously. Arthritis may involve one joint or several joints asymmetrically or symmetrically. Spinal involvement occurs in some patients. Peripheral joint involvement is most common in the distal interphalangeal joints of the hands, which have a characteristic sausage-like appearance. Nail changes include pitting, transverse ridges, onycholysis, keratosis, yellowing, and destruction. The patient may experience general malaise, fever, and eye involvement.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Diseases, 2003

Rheumatoid arthritis: Signs and symptoms
(Handbook of Diseases)

RA usually develops insidiously and initially produces nonspecific signs and symptoms. These include fatigue, malaise, anorexia, persistent low-grade fever, weight loss, lymphadenopathy, and vague articular symptoms.

Specific symptoms

As the disease progresses, more specific localized articular symptoms develop, commonly in the fingers at the proximal interphalangeal (PIP), metacarpophalangeal (MCP), and metatarsophalangeal joints. These symptoms usually occur bilaterally and symmetrically and may extend to the wrists, knees, elbows, and ankles.

The affected joints stiffen after inactivity, especially on rising in the morning. The fingers may assume a spindle shape from marked edema and congestion in the joints. The joints become tender and painful, at first only when the patient moves them, but eventually even at rest. They often feel hot to the touch. Ultimately, joint function is diminished. Deformities are common if active disease continues.

PIP joints may develop flexion deformities or become hyperextended. MCP joints may swell dorsally, and volar subluxation and stretching of tendons may pull the fingers to the ulnar side (“ulnar drift”).

The fingers may become fixed in a characteristic swan-neck or boutonnière deformity. The hands appear foreshortened and, the wrists boggy; carpal tunnel syndrome from synovial pressure on the median nerve causes paresthesia in the fingers.

CLINICAL TIP: Early intervention, under the guidance of an occupational therapist, with splinting and joint protection devices can effectively delay the progression of joint deformities.

Extra-articular signs

The most common extra-articular finding is the gradual appearance of rheumatoid nodules — subcutaneous, round or oval, nontender masses. These are seen in 20% of RA patients who are RF-positive. They usually appear on pressure areas, such as the elbows, hands, and Achilles tendon.

Vasculitis can lead to skin lesions, leg ulcers, and multiple systemic complications. Peripheral neuropathy may produce numbness or tingling in the feet or weakness and loss of sensation in the fingers. Stiff, weak, or painful muscles are common.

Other common extra-articular effects include pericarditis, pulmonary nodules or fibrosis, pleuritis, scleritis, and episcleritis.

Other complications

Another complication is destruction of the odontoid process, which is part of the second cervical vertebra. With C₁ or C₂ instability and subluxation, spinal cord compression may occur, particularly in patients with long-standing deforming RA. Upper-motor-neuron signs and symptoms, such as a positive Babinski’s sign and muscle weakness, may also develop.

RA can also cause temporomandibular joint disease, which impairs chewing and causes earaches. Other extra-articular findings include infection, osteoporosis, myositis, cardiopulmonary lesions, lymphadenopathy, and peripheral neuritis.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Diseases, 2003

Juvenile rheumatoid arthritis: Signs and symptoms
(Handbook of Diseases)

Signs and symptoms vary with the type of JRA.

Systemic JRA

Affecting boys and girls almost equally, systemic JRA accounts for 20% to 30% of cases. Affected children may have mild, transient arthritis or frank poly-arthritis associated with fever and rash.

CLINICAL TIP: Joint involvement may not be evident at first, but the child’s behavior may clearly suggest joint pain. Such a child may want to constantly sit in a flexed position, may not walk much, or may refuse to walk at all. Young children with JRA are noticeably irritable and listless.

Fever in systemic JRA occurs suddenly and spikes to 103° F (39.4° C) or higher once or twice daily, usually in the late afternoon, then rapidly returns to normal or subnormal. (This sawtooth, or intermittent spiking, fever pattern helps differentiate JRA from other inflammatory disorders.) When fever spikes, an evanescent rheumatoid rash typically appears, consisting of small, pale or salmon pink macules, most commonly on the trunk and proximal extremities and occasionally on the face, palms, and soles.

Massaging or applying heat intensifies this rash, which is usually most conspicuous where the skin has been rubbed or subjected to pressure, such as that from underclothing.

Other signs and symptoms of systemic JRA include hepatosplenomegaly, lymphadenopathy, pleuritis, pericarditis, myocarditis, and nonspecific abdominal pain.

Polyarticular JRA

Polyarticular JRA is four to nine times more common in girls than in boys and may be seronegative or seropositive for rheumatoid factor (RF). It involves five or more joints and usually develops insidiously. The joints most commonly involved are the wrists, elbows, knees, ankles, and small joints of the hands and feet.

Polyarticular JRA can also affect larger joints, including the temporomandibular joints and those of the cervical spine, hips, and shoulders. These joints become swollen, tender, and stiff.

Usually, the arthritis is symmetrical; it may be remittent or indolent. The patient may run a low-grade fever with daily peaks. Listlessness and weight loss can occur, possibly with lymphaden-opathy and hepatosplenomegaly. Other signs of polyarticular JRA include subcutaneous nodules on the elbows or heels and noticeable developmental retardation.

Seropositive polyarticular JRA, the more severe type, usually occurs late in childhood and can cause destructive arthritis that mimics adult RA.

Pauciarticular JRA

Involving few joints (usually no more than four), pauciarticular JRA usually affects the knees and other large joints. It accounts for 45% of cases. Three major subtypes exist:

❑ Pauciarticular JRA with chronic iridocyclitis most commonly affects girls younger than age 6 and involves the knees, elbows, ankles, or iris. Inflammation of the iris and ciliary body is typically asymptomatic, but may produce pain, redness, blurred vision, and photophobia. Young girls who test positive for antinuclear antibodies (ANAs) are at highest risk for eye complications.

❑ Pauciarticular JRA with sacroiliitis usually affects boys (9:1) older than age 8, who tend to be human leukocyte antigen (HLA)-B27–positive. This subtype is characterized by lower-extremity arthritis that produces hip, sacroiliac, heel, and foot pain and Achilles tendinitis. These patients may later develop the sacroiliac and lumbar arthritis characteristic of ankylosing spondylitis. Some patients also experience acute iritis, but not as many as those with the first subtype.

❑ The third subtype includes patients with joint involvement who test negative for ANAs and HLA-B27 and who don’t develop iritis. Characterized by asymmetrical involvement of large or small joints, this subtype can strike at any age during childhood. These patients have a better prognosis than those with the first or second subtype, although some may progress to polyarticular disease.

Common to all types of JRA is joint stiffness in the morning or after periods of inactivity. Growth disturbances may also occur, resulting in overgrowth or undergrowth adjacent to inflamed joints.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Diseases, 2003

Septic arthritis: Signs and symptoms
(Handbook of Diseases)

Acute septic arthritis begins abruptly, causing intense pain, inflammation, and swelling of the affected joint, with low-grade fever. Although it usually affects a single, large joint, it can affect any joint, including the spine and small peripheral joints.

CLINICAL TIP: Systemic signs of inflammation may not appear in some patients. Migratory polyarthritis sometimes precedes localization of the infection. If the bacteria invade the hip, pain may occur in the groin, upper thigh, or buttock, or may be referred to the knee.

UNDER STUDY:  The tumor necrosis factor (TNF) 2 allele has been associated with higher septic shock susceptibility and mortality. Investigation of polymorphisms within the TNF alpha cluster will be important in understanding the role of TNF alpha regulation in specific diseases.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Diseases, 2003

Hypothyroidism in adults: Signs and symptoms
(Handbook of Diseases)

Typically, the early clinical features of hypothyroidism are vague and may include fatigue, forgetfulness, sensitivity to cold, unexplained weight gain, and constipation. As the disorder progresses, characteristic myxedematous signs and symptoms appear, such as decreasing mental stability; dry, flaky, inelastic skin; puffy face, hands, and feet; hoarseness; periorbital edema; upper eyelid droop; dry, sparse hair; and thick, brittle nails.

Cardiovascular involvement leads to decreased cardiac output, slow pulse rate, signs of poor peripheral circulation and, occasionally, an enlarged heart. Other common effects include anorexia, abdominal distention, menorrhagia, decreased libido, infertility, ataxia, and nystagmus. Reflexes show delayed relaxation time (especially in the Achilles tendon).

Progression to myxedema coma is usually gradual, but when stress aggravates severe or prolonged hypothyroidism, coma may develop abruptly. Clinical effects include progressive stupor, hypoventilation, hypoglycemia, hyponatremia, hypotension, and hypothermia.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Diseases, 2003

Neutropenia: Neutropenia - signs & symptoms
(The 5-Minute Pediatric Consult)

• Fever (temperature should not be taken rectally) tachycardia, and hypotension may indicate systemic infection.
• Oral ulceration, gingival irritation, pharyngitis, thrush
• Cellulitis, perirectal, or labial abscesses
• Hepatomegaly or splenomegaly
• Bruises, petechiae, pallor (other cell lines may be involved)
• Phenotypic abnormalities (thumb anomalies, dwarfism, joint findings)
• Systemic infection: Fever, rash, upper respiratory symptoms, jaundice

» READ BOOK EXCERPT ONLINE »

Source: The 5-Minute Pediatric Consult, 2008

Fever and Neutropenia: Presentation
(Pediatric Infectious Disease)

Fever in the neutropenic patient is usually defined as a single temperature greater than 38.3 °C, (101.3°F) or a sustained temperature of 38°C (100.4°F) temperature for more than 1 hour.

» READ BOOK EXCERPT ONLINE »

Source: Pediatric Infectious Disease, 2004

Osteomyelitis and Septic Arthritis: Presentation
(Pediatric Infectious Disease)

The hallmark of pediatric osteomyelitis or septic arthritis is fever and localized pain. In the toddler whose verbal skills may not be sufficiently developed, the presentation may be simply fever and refusal to walk. It is for this reason that for many clinicians, fever and refusal to walk in a child indicates osteomyelitis or septic arthritis until proven otherwise. Septic arthritis of the hip is of particular concern to pediatricians because this joint space cannot be visualized directly on physical examination.

» READ BOOK EXCERPT ONLINE »

Source: Pediatric Infectious Disease, 2004

Article Excerpts About Symptoms of Rheumatoid arthritis:

Handout on Health Rheumatoid Arthritis: NIAMS (Excerpt)

Rheumatoid arthritis is an inflammatory disease that causes pain, swelling, stiffness, and loss of function in the joints. It has several special features that make it different from other kinds of arthritis (see information box below). For example, rheumatoid arthritis generally occurs in a symmetrical pattern. This means that if one knee or hand is involved, the other one is also. The disease often affects the wrist joints and the finger joints closest to the hand. It can also affect other parts of the body besides the joints (see illustrations below). In addition, people with the disease may have fatigue, occasional fever, and a general sense of not feeling well (malaise).

Another feature of rheumatoid arthritis is that it varies a lot from person to person. For some people, it lasts only a few months or a year or two and goes away without causing any noticeable damage. Other people have mild or moderate disease, with periods of worsening symptoms, called flares, and periods in which they feel better, called remissions. Still others have severe disease that is active most of the time, lasts for many years, and leads to serious joint damage and disability.

Although rheumatoid arthritis can have serious effects on a person's life and well-being, current treatment strategies--including pain relief and other medications, a balance between rest and exercise, and patient education and support programs--allow most people with the disease to lead active and productive lives. In recent years, research has led to a new understanding of rheumatoid arthritis and has increased the likelihood that, in time, researchers can find ways to greatly reduce the impact of this disease.

Handout on Health Rheumatoid Arthritis: NIAMS (Excerpt)

Some people also experience the effects of rheumatoid arthritis in places other than the joints. About one-quarter develop rheumatoid nodules. These are bumps under the skin that often form close to the joints. Many people with rheumatoid arthritis develop anemia, or a decrease in the normal number of red blood cells. Other effects, which occur less often, include neck pain and dry eyes and mouth. Very rarely, people may have inflammation of the blood vessels, the lining of the lungs, or the sac enclosing the heart. (Source: excerpt from Handout on Health Rheumatoid Arthritis: NIAMS)

Understanding Autoimmune Disease: NIAID (Excerpt)

In people with rheumatoid arthritis, the immune system predominantly targets the lining (synovium) that covers various joints. Inflammation of the synovium is usually symmetrical (occurring equally on both sides of the body) and causes pain, swelling, and stiffness of the joints. These features distinguish rheumatoid arthritis from osteoarthritis, which is a more common and degenerative "wear-and-tear" arthritis. (Source: excerpt from Understanding Autoimmune Disease: NIAID)

Arthritis: NWHIC (Excerpt)

In rheumatoid arthritis, the hands are most commonly affected, but it can affect most joints of the body. Inflammation begins in the synovial lining and can spread to the entire joint.

Painful and knobby bone growths in the fingers are common, but usually not crippling to osteoarthritis. The disease is often mild, but can be quite severe. (Source: excerpt from Arthritis: NWHIC)

Arthritis Advice - Age Page - Health Information: NIA (Excerpt)

Rheumatoid arthritis (RA) can be one of the more disabling forms of arthritis. Signs of RA often include morning stiffness, swelling in three or more joints, swelling of the same joints on both sides of the body (both hands, for example), and bumps (or nodules) under the skin most commonly found near the elbow. RA can occur at any age and affects women about three times more often than men. (Source: excerpt from Arthritis Advice - Age Page - Health Information: NIA)

Rheumatoid arthritis as a Cause of Symptoms or Medical Conditions

When considering symptoms of Rheumatoid arthritis, it is also important to consider Rheumatoid arthritis as a possible cause of other medical conditions. The Disease Database lists the following medical conditions that Rheumatoid arthritis may cause:

• AA amyloidosis
• Angiotensin converting enzyme levels raised (plasma or serum)
• Aortic valve incompetence
• Arthropathy
• Aseptic necrosis of bone
• Atlantoaxial subluxation
• Autoantibodies
• Bursitis
• Carpal tunnel syndrome
• Coin lesion (chest x-ray)
• Complement C3 levels low (serum)
• Complement C4 levels low (serum)
• Cryoglobulinaemia
• Dysphonia
• Eosinophilia
• Episcleritis
• ESR raised
• Ferritin levels raised (serum)
• Genu valgum
• Hypersplenism
• Immunoglobulin levels raised (plasma or serum)
• LE cell
• Lung cavity
• Lymphadenopathy
• Lymphoedema
• Mitral valve incompetence
• Monocytosis
• Mononeuritis multiplex
• Neutropenia
• Osteoporosis
• Palmar erythema
• Pericarditis
• Pleural effusion
• Pleuritis
• Proteinuria
• Pulmonary fibrosis
• Pure red cell aplasia
• Pyoderma gangrenosum
• Pyrexia of unknown origin
• Raynaud's phenomenon
• Red cell production reduced
• Scleritis
• Sideroblasts
• Spondylolisthesis
• Stridor
• Subcutaneous nodules
• Synovitis
• Tendon nodules
• Thrombocytosis
• Transferrin levels low (serum)
• Uveitis
• Vasculitis
• VDRL positive

Rheumatoid arthritis as a symptom:

For a more detailed analysis of Rheumatoid arthritis as a symptom, including causes, drug side effect causes, and drug interaction causes, please see our Symptom Center information for Rheumatoid arthritis.

Medical articles and books on symptoms:

These general reference articles may be of interest in relation to medical signs and symptoms of disease in general:

• Diagnostic Testing for a Diagnosis of Rheumatoid arthritis
• Research Alternative Diagnoses for Rheumatoid arthritis
• How serious is Rheumatoid arthritis?
• More about Rheumatoid arthritis
• Online Diagnosis
• Self Diagnosis Pitfalls
• Pitfalls of Online Diagnosis
• Symptoms of the Silent Killer Diseases
• Lesser known silent killer diseases
• Books on signs and symptoms

Full list of premium articles on symptoms and diagnosis

About signs and symptoms of Rheumatoid arthritis:

The symptom information on this page attempts to provide a list of some possible signs and symptoms of Rheumatoid arthritis. This signs and symptoms information for Rheumatoid arthritis has been gathered from various sources, may not be fully accurate, and may not be the full list of Rheumatoid arthritis signs or Rheumatoid arthritis symptoms. Furthermore, signs and symptoms of Rheumatoid arthritis may vary on an individual basis for each patient. Only your doctor can provide adequate diagnosis of any signs or symptoms and whether they are indeed Rheumatoid arthritis symptoms.