Diagnosing rheumatoid arthritis (RA) in the early stages can be difficult. There is no single test that can clearly identify rheumatoid arthritis. Instead, doctors diagnose rheumatoid arthritis based on factors that are strongly associated with the disease. The American College of Rheumatology uses this list of criteria:
Morning stiffness in and around the joints for at least one hour.
Swelling or fluid around three or more joints simultaneously.
At least one swollen area in the wrist,...
Rheumatoid arthritis mainly affects joints. It causes:
Any joint can be affected by RA. But the joints most often affected include:
Knuckles of the hands
Rheumatoid arthritis inflames other joints less often. These include some areas of the body that most people don't realize have joints, such as the:
Morning stiffness is a common symptom of rheumatoid arthritis. The joints of RA patients with morning stiffness are particularly stiff first thing in the morning. The stiffness improves somewhat after at least an hour of movement.
RA typically involves more than one joint. Often, but not always, joints on both sides of the body (“symmetrical,” such as both wrists) are equally affected.
RA Symptoms Away From the Joints
Although rheumatoid arthritis almost always affects joints, it can also involve other areas of the body. The resulting inflammation can lead to varied symptoms outside the joints, such as:
Painful lumps under the skin (nodules)
Eye pain and redness
Shortness of breath
Carpal tunnel syndrome
Dry eyes (Sjogren's syndrome)
Progression of RA Symptoms
The progression of symptoms in rheumatoid arthritis varies widely. Some people with RA have a steady progression of disease with joint damage. Others have mild symptoms that never worsen.
In a few people with rheumatoid arthritis, symptoms may come in episodes or flares. These flares can be separated by months without any symptoms.
More often, symptoms of rheumatoid arthritis are persistent. They occur on most days. The symptoms may be worse on some days than others.
No two people with rheumatoid arthritis may have exactly the same pattern of symptoms. Recent advances in rheumatoid arthritis treatments have resulted in better symptom control and reduced progression of disease for many people with RA.