Symptoms:

The disease usually begins gradually with:

• Fatigue
• Loss of appetite
• Morning stiffness (lasting more than 1 hour)
• Widespread muscle aches
• Weakness

Eventually, joint pain appears. When the joint is not used for a while, it can become warm, tender, and stiff. When the lining of the joint becomes inflamed, it gives off more fluid and the joint becomes swollen. Joint pain is often felt on both sides of the body, and may affect the fingers, wrists, elbows, shoulders, hips, knees, ankles, toes, and neck.

Additional symptoms include:

• Anemia due to failure of the bone marrow to produce enough new red blood cells
• Eye burning, itching, and discharge
• Hand and feet deformities
• Limited range of motion
• Low-grade fever
• Lung inflammation (pleurisy)
• Nodules under the skin (usually a sign of more severe disease)
• Numbness or tingling
• Paleness
• Skin redness or inflammation
• Swollen glands

Joint destruction may occur within 1-2 years after the appearance of the disease.

Signs and tests:

A specific blood test is available for diagnosing RA and distinguishing it from other types of arthritis. It is called the anti-CCP antibody test. Other tests that may be done include:

• Complete blood count
• C-reactive protein
• Erythrocyte sedimentation rate
• Joint ultrasound or MRI
• Joint x-rays
• Rheumatoid factor test (positive in about 75% of people with symptoms)
• Synovial fluid analysis