While rheumatoid arthritis primarily affects joints, problems involving other organs of the body are known to occur. Extra – articular (“outside the joints”) manifestations other than anemia (which is very common) are clinically evident in about 15–25% of individuals with rheumatoid arthritis.
Signs and symptoms of rheumatoid arthritis may include:
• Joint pain
• Joint swelling
• Joints that are tender to the touch
• Red and puffy hands
• Firm bumps of tissue under the skin on your arms (rheumatoid nodules)
• Morning stiffness that may last for hours
• Weight loss
• Numbness, tingling, or burning in the hands and feet
The arthritis of joints known as synovitis is inflammation of the synovial membrane that lines joints and tendon sheaths. Joints become swollen, tender and warm, and stiffness limits their movement. The hallmark symptom of rheumatoid arthritis is morning stiffness that lasts for at least an hour. (Stiffness from osteoarthritis, for instance, usually clears up within half an hour.) Even after remaining motionless for a few moments, the body can stiffen.
Movement becomes easier again after loosening up. The rheumatoid nodule, which is often subcutaneous, is the cutaneous feature most characteristic of rheumatoid arthritis. The initial pathologic process in nodule formation is unknown but may be essentially the same as the synovitis, since similar structural features occur in both. In children, juvenile rheumatoid arthritis, also known as Still’s disease, is usually preceded by high fever and shaking chills along with pain and swelling in many joints. A pink skin rash may be present.
Fibrosis of the lungs is a recognized response to rheumatoid disease. It is also a rare but well recognized consequence of therapy (for example with methotrexate and leflunomide). Women are affected more often than men. Renal amyloidosis can occur as a consequence of chronic inflammation. There is some evidence to suggest that if you have an inflammatory condition such as rheumatoid arthritis, you may be at a greater risk of heart disease. People with rheumatoid arthritis are more prone to atherosclerosis, and risk of myocardial infarction (heart attack) and stroke is markedly increased.