This autoimmune attack causes joint inflammation, the hallmark of RA. When inflamed, the synovium releases damaging chemicals to nearby areas. Over time, inflammation can not only damage and deform the joints — and the cartilage and bones within the joints — but also affect surrounding muscles, ligaments, and tendons that support the joints.
Classic Rheumatoid Arthritis Disease Progression
The main signs of RA are joint swelling, pain, and stiffness. Most case of RA are polyarticular, meaning the disease affects five or more joints at once. Some people experience a sudden onset of polyarticular symptoms over 24 to 48 hours.
Palindromic Rheumatism Disease Progression
Though most people experience this classic disease progression, others experience palindromic rheumatism.
Fatigue or tirednessMalaiseDepressionLow-grade feverDecreased appetite and weight lossSweating
Swan-neck, in which the joint at the base of the finger and the outermost joint bend in while the middle joint straightensHitchhiker’s thumb (also known as Z-shaped deformity), in which the joint at the base of the thumb bends in and the joint below the thumbnail bends backwardHammertoe (or claw toe), in which the toes either bend up from the joints at the ball of the foot, down at the middle joints, or down at the top toe joints (curling under the foot)Boutonniere, in which the joint nearest the knuckle bends toward the palm and the outer joint bends away from it, per OrthoInfo
Feet and heelsKneesFingersBack of the headBase of the spineTendons of the handAchilles tendon
Eye pain and vision problems from inflammation in the eyeDry eyes and dry mouth from Sjogren’s syndrome, an inflammatory condition of the tear and saliva glands that affects 10 to 15 percent of people with RAPericarditis, or painful breathing and chest pain from inflammation of the tissue lining the chest cavity and surrounding the heartPleurisy, an inflammation of the lining of the lung causing pain and shortness of breathTingling, pain, numbness, or burning sensation in hands and feet from an inflammation affecting the nervesFatigue, muscle pain, kidney problems, rash, weight loss, and other issues from vasculitis (inflammation of the blood vessels)
These episodes of increased disease activity are called “flares,” and they’re an indication that the immune system is attacking the body more than usual. Flares can be predictable, brought on by specific triggers. Known triggers include physical stress, such as from exercise, surgery, injuries, infections, or medication changes, or from emotional stress, such as from work or family issues. Other times, flares can spring up out of nowhere without a clear cause. Unlike with stress-related flares, unpredictable flares may not subside on their own and may require medication or a visit to the doctor.
