Symptoms

Most often the onset of RA is marked by fatigue, weakness, low-grade fever, or loss of appetite and weight. Such symptoms may or may not be accompanied by mild joint stiffness or pain. When present, stiffness is most prominent in the morning and improves during the day. The period of stiffness lengthens when the disease is more active and tends to increase after strenuous activity. The joints that most often become inflamed (red, warm, swollen, and painful) are those of the finger, wrist, elbow, knee, ankle, or toe--typically on both sides of the body. This symmetric pattern and the signs of inflammation distinguish RA from osteoarthritis (OA), another, more common type of arthritis.

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Also, unlike osteoarthritis, the joints at the tips of the fingers are generally not affected by RA. Another characteristic feature of RA is the formation of hard bumps under the skin, called rheumatoid nodules. Rheumatoid nodules can be found in tissues throughout the body, especially around the joints.

In active RA, the joints are inflamed and progressive joint damage occurs. Active RA may include periods of worsening inflammation called flare-ups, or flares. Joint damage stops only when the disease is controlled with medication. Occasionally, the disease goes into remission and medications can be discontinued.