What are the symptoms of rheumatoid arthritis?

Diseases like rheumatoid arthritis are very common, and everyone should have some understanding of them. Many people are deeply tormented by such diseases, especially among women. Rheumatoid arthritis is very common, and there are many types of rheumatoid arthritis. The pain is very obvious, especially in some sensitive seasons. Let's see the symptoms of rheumatoid arthritis.

The symptoms of rheumatoid arthritis are generally very serious in the late stages. If not treated in time, it can lead to paralysis and other infections, endangering the patient's life. Everyone should understand the symptoms of rheumatoid arthritis and be able to seek treatment as soon as possible if these symptoms are discovered.

(1) Morning stiffness

The subjective feeling of joint stiffness upon waking up in the morning is a nonspecific manifestation of joint inflammation, the duration of which is proportional to the severity of the inflammation.

(2) Manifestations of joint involvement

①Multiple joint involvement

Symmetric polyarthritis (usually ≥ 5 joints). The joints that are easily affected include the hands, feet, wrists, ankles and temporomandibular joints, and others may include the elbows, shoulders, cervical vertebrae, hips, knees, etc.

② Joint deformity

Hand deformities include fusiform swelling, ulnar deviation, swan neck deformity, buttonhole deformity, etc. Foot deformities include calcaneal deformity caused by downward subluxation of the metatarsal head, valgus deformity, metatarsophalangeal joint subluxation, hammer toe and valgus deformity.

③Others

There may be carpal tunnel/tarsal tunnel syndrome caused by compression of the median nerve/posterior tibial nerve, fluid accumulation in the knee joint cavity squeezing into the posterior side of the joint to form a popliteal cyst (Baker cyst), involvement of the cervical spine (most commonly the 2nd and 3rd cervical vertebrae) may cause neck pain, neck weakness and difficulty in maintaining its normal position, atlantoaxial joint subluxation, and corresponding manifestations of spinal cord compression and vertebral basilar artery insufficiency.

(3) Extra-articular manifestations

① General manifestations

There may be fever, rheumatoid nodules (which are organizing granulomas, associated with high titer RF, severe joint destruction and RA activity, and are prone to occur in joint prominences such as the elbows, olecranon processes, sacrum, and other areas of frequent pressure), rheumatoid vasculitis (necrotizing arteritis that mainly affects small arteries, which can manifest as necrosis of the finger and toe tips, skin ulcers, peripheral neuropathy, etc.) and lymphadenopathy. ② Heart involvement

Symptoms may include pericarditis, pericardial effusion, epicardial, myocardial and valvular nodules, myocarditis, coronary arteritis, aortitis, conduction disorders, chronic endocarditis and valvular fibrosis.

③Respiratory system involvement

There may be pleurisy, pleural effusion, pulmonary arteritis, interstitial lung disease, nodular lung disease, etc.

④ Renal manifestations

The main types include primary glomerular and tubulointerstitial nephritis, renal amyloidosis and renal damage secondary to drug treatment (gold preparations, penicillamine and NSAIDs).

⑤ Nervous system

In addition to the symptoms of peripheral nerve compression, it can also induce neurological diseases, myelopathy, peripheral neuropathy, ischemic neuropathy secondary to vasculitis, muscle hypertrophy and drug-induced nervous system diseases.

⑥Anemia

It is the most common extra-articular manifestation of RA and is anemia of chronic disease, which is usually mild to moderate. ⑦ The digestive system may be caused by RA vasculitis, complications or drug treatment. ⑧Eye

Young patients may have uveitis, and adults may have scleritis, which may be caused by vasculitis. There may also be sicca conjunctivitis keratitis, scleral softening, scleral softening perforation, and corneal dissolution.

(4) Felty syndrome

1% of RA patients may have splenomegaly, neutropenia (and thrombocytopenia, decreased red blood cell count), often with severe joint lesions, high titer RF and ANA positivity, which is a severe type of RA.

(5) Remitted seronegative, symmetrical synovitis

RS3PE is more common in men, usually after the age of 55, with acute onset, symmetrical inflammation of the wrist joints, flexor tendon sheaths and small joints of the hands, and pitting edema on the back of the hands. Morning stiffness lasts for a long time (0.5 to 1 day), but RF is negative and X-rays often show no bone destruction. 56% of the patients were HLA-B7 positive. The patient responds poorly to NSAIDs alone, but low-dose glucocorticoids are effective. It usually resolves spontaneously after 1 year and has a good prognosis.

(6) Adult-onset Still's disease (AOSD)

A rare type of RA characterized by alternating acute attacks and remissions of high fever, arthritis, and rash. It is named because its clinical manifestations are similar to systemic juvenile rheumatoid arthritis (Still's disease). Some patients develop typical RA after several attacks.

Everyone should understand the symptoms of rheumatoid arthritis. Only by knowing the symptoms of these diseases can we discover them as early as possible and treat them as early as possible. Early treatment is also very important. Patients must have enough confidence that they can cure this disease. The most important thing is to cooperate well with the doctor for treatment and develop good habits.