Rheumatoid arthritis (RA) causes long-term inflammation in the joints. This can change the shape of the joints, often in the hands, including the fingers, and the feet.
RA can affect any joint in the body and can cause lasting changes in the shape and structure of the joints. It
RA affects around 1.3 million people in the United States and around 1% of people worldwide.
Doctors can assess and visualize the effects of RA using imaging methods, such as X-rays and ultrasound and MRI scans.
This article discusses the symptoms of RA and its effects on different parts of the body. It also explores the classifications of RA and provides pictures of the condition.
A joint is a point in the body where two bones
- fibrous joints
- cartilaginous joints
- synovial joints
The primary symptom of RA is inflammation in the joints, which causes:
The physical effects of RA in the joints can include:
- changes in the shape of joints
- nodules, which are small, firm lumps near the joint
- inflamed bursa, or bursitis, wherein fluid accumulates in the bursa near joints and may become visible
- circulation problems, which can cause fingers or toes to turn blue
RA in the joints can also lead to vasculitis, which can cause small lesions to appear around the fingers, nails, or lower legs. However, this is becoming less common due to effective treatments and improved ways of detecting RA at an early stage.
Symptoms of RA tend to come and go in phases called flares. These flares can develop over many weeks, but they can also appear rapidly within a few days.
Alongside changes in the joints, RA can cause other symptoms,
- appetite changes
- weight loss
- limited mobility
Classifications of RA
RA can present in different ways, with each type producing slightly different symptoms.
Polyarthritis is not a separate type of arthritis but a pattern of arthritis. Polyarthritis occurs when arthritis affects five or more joints.
Polyarthritis typically involves chronic inflammation and can have a severe impact on mobility.
There are several types of polyarthritis, which can impact the body in different ways. For example, lupus is a type of polyarthritis that can also affect the skin, kidneys, and central nervous system.
Juvenile arthritis, or pediatric rheumatic disease, refers to a group of autoimmune and inflammatory conditions that affect individuals under the age of 16 years.
One of the most common forms of arthritis, juvenile idiopathic arthritis (JIA), falls under this category.
There are several types of JIA, and symptoms vary between them. However, inflammation in the joints is common to them all.
The swelling and stiffness in the hands typically peak in the morning, then gradually decline throughout the day.
Extended periods of inflammation can cause the finger and wrist joints to change shape. This has a significant impact on the mobility of the hands, which can make it more difficult for people to perform daily tasks.
RA can also develop in the joints of the foot and ankle. Up to 90% of individuals with RA will experience symptoms in their feet.
Moreover, people often have symptoms in their little toe before signs appear in their hands.
A person may notice the symptoms in their feet, because they can affect mobility. This is because walking exerts a constant pressure in and around the feet.
The most commonly affected foot joints include the:
- small joints in the toes, called interphalangeal joints
- large joint on the big toe, called the metatarsophalangeal (MTP) joint
- joint connecting the foot with the ankle, called the subtalar joint
- ankle joint, although this is less common
RA can damage tendons, ligaments, and other tissues surrounding joints. For example, it can affect the Achilles tendon, which connects the calf to the heel bone. Nodules can also appear in this area.
Damage to the tendons can cause the toes to become twisted, leading them to cross over each other. The toes may curl downward and appear claw-like in shape. This condition is commonly known as hammer toe.
Damage to the tendons and ligaments in the middle of the foot can cause the arch of the foot to collapse.
Problems with the MTP joint can create bony protrusions on the sole, which is painful and may affect how a person walks.
Changes to the shape of the toes and feet can cause the joints to rub on shoes, or the toes to rub against each other. This can cause other issues, such as:
Many people will only experience mobility issues when they have an RA flare-up. Flare-ups may last for several months if a person does not receive effective treatment.
The knee joint contains cartilage to prevent the bones from scraping against each other. Inflammation can damage this cartilage, causing the bones to rub together. This tends to occur in people who experience chronic RA or do not receive effective treatment to manage the inflammation.
Some individuals may also develop unusual bone growths in the knees, called osteophytes.
RA in the knee can cause pain and stiffness and may affect a person’s walking and mobility.
As RA progresses, it may develop in other joints in the body as well.
For instance, RA may affect the spine, including the lower back and the neck region.
A person with RA that affects the lumbar spine may experience lower back pain and bone fractures. An individual with RA that affects the cervical spine may experience neck pain and difficulty turning their head.
- jaw pain
- difficulty in jaw movements, including biting and chewing food
Additionally, RA may develop elsewhere in the body,
- heart: People with RA may experience pericarditis.
- lungs: RA may lead to:
- blood: RA may cause RA vasculitis, which leads to the inflammation and narrowing of small and medium-sized blood vessels in the body. Symptoms may include numbness, tingling, and pain, particularly in the fingers and toes.
- nerves: RA
can affectthe peripheral nerves of the body, resulting in peripheral neuropathy. These nerves connect the brain and spinal cord to other body parts. Symptoms may include:
- muscle weakness
- eyes: RA may develop in the eyes, including the whites of the eyes and the lens cap, or cornea. RA-related eye conditions include:
RA affects people in different ways. The differences will often depend on which joints have become inflamed. For example, inflammation in the ankle and foot joints may restrict a person’s ability to walk.
These issues are usually temporary, because symptoms tend to flare up and then go away. Sometimes, however, these flare-ups can last for months.
Doctors can usually recommend treatments that prevent prolonged flares and subsequent damage.
A person should consider contacting a healthcare professional if they are experiencing symptoms related to RA.