What Everyone Needs to Know About Early Signs of Rheumatoid Arthritis (RA)
As you know, the incidence of autoimmune diseases is increasing in the United States. Rheumatoid Arthritis is one of those diseases that is on the rise. It is one of the most debilitating forms of arthritis. For that reason, both primary care providers and the general public need to recognize the early signs of Rheumatoid Arthritis.
The National Institutes of Health recently published a Journal of the Royal Society of Medicine article that addresses the importance of referral to a Rheumatologist when a patient is experiencing early signs of Rheumatoid Arthritis for the following reasons:
- Rheumatologist are trained to prescribe disease- modifying- antirheumatic-drugs (DMARD) to try to slow or arrest the progression of the disease.
- Patients with early RA who have these drugs introduced early have better chance of avoiding the serious joint damage that RA can cause.
There are many difficulties with diagnosing RA in the early stages of the disease
- Only about 70% of people with a firm diagnosis of RA have a positive Rheumatoid factor
- Plain x-rays of hands and feet can be normal in people with early RA
- Not all people who have early joint inflammation develop RA
- Many conditions can present as RA and actually mimic the disease but they are not RA. (examples: osteoarthritis and gout)
Who should be referred to a specialist for a second opinion?:
- patients with joint pain that has persisted for 6-8 weeks
- patients with joint swelling
- patients who experience pain when their joints are compressed, especially in the joints of their hands and feet
- patients who have early morning stiffness that persists for 30-60 minutes
- patients with raised inflammatory blood test markers such as ESR and C-Reactive Protein
- patients with a positive Rheumatoid Factor
What are some Unusual Signs of Early Rheumatiod Arthritis?
- Most people believe that the hands are always involved first and that RA signs are usually bilateral. My RA was first diagnosed in my left shoulder. It was many years later that it was diagnosed in my right shoulder too. Yet, both of my hands have always been involved.
- I have a friend who first got RA in her eye
- Heart disease is another autoimmune disease that is caused by RA
- Ankle pain and damage
- Swollen Elbows
- Painful hips
- Painful knees
- Intestinal inflammation
This is why it is so difficult to get a firm diagnosis of arthritis and why it is important for you to get a specialist’s opinion. Rheumatologists are trained to sort out all of the different early signs of RA and make an educated decision about a Rheumatiod Arthritis diagnosis.