Ailments and Situations - Arthritis - Symptoms and Signs

Osteoarthritis affects the knees, hips, spine, and the two joints closest to the end of your fingers (distal and proximal interphalangeal (DIP, PIP) joints). This gradual process usually affects only one or a few joints and typically only affects one side of the body. Distal interphalangeal (DIP) joints -- the ones closest to the tips of your fingers or toes -- are always affected. The first carpometacarpal joint (on your hand) and the first metatarsophalangeal joint (on your foot) are also affected.

Over time, joints become more stiff and pain increases as joint cartilage continues to degenerate. Range of motion is also reduced.

Pain becomes more severe as bone rubs against bone when one or more joints are moved. Pain is made worse with exercise and made better with rest.

RA usually develops on both sides of the body and is characterized by crippling pain, symmetric inflammation, chronic stiffness, fatigue, contractures, and a hot, burning sensation in the peripheral joints, particularly the ankles, knees, elbows, wrists, hands, and fingers.

Other signs may include anemia, weight loss, fever, lower back pain, joint thickening, swelling, and tenderness, nodules around the joints, and moderate to severe motion impairment in affected joints.

Symptoms are often worse in the morning upon waking and improve over the course of the day.

Proximal interphalangeal (PIP) joints -- the second and third joints in from the tips of your fingers -- are always affected. Metacarpophalangeal joints in the hand and metatarsophalangeal joints in the foot are also affected.

Systemic Lupus Erythematosus (SLE) can mimic RA. Your naturopath or other health practitioner will help rule out this possibility. Additional systemic diseases involving joints, such as Sarcoidosis, amyloidosis, and Whipple's disease can also cause symptoms similar to RA. A tissue biopsy will rule out these possibilities.

According to the Rheumatoid Arthritis Association diagnostic criteria (1987), four of the following seven criteria must be present to be classified as RA. In addition, the first four criteria must be present for at least six weeks:

1.  
   1. Morning stiffness in and around joints lasting at least one hour before maximal improvement.
   2. Soft tissue swelling (arthritis) of 3 or more joints observed by a physician.
   3. Swelling of the pip (proximal interphalangeal joints), mcp (meta carpal), or wrist joints.
   4. Symmetric joint swelling with simultaneous involvement of the same joint on both sides of the body.
   5. Rheumatoid nodules over bony prominences on the extensor surfaces or in juxtaarticular regions.
   6. Rheumatoid Factor (RA-causing antibodies tested through a blood test).
   7. X-ray changes typical of RA (bony decalcification either localized or greatest around the involved joints).