by Mai-Trinh T. Pham, MD, Palmetto Family Medicine

Rheumatoid arthritis (RA) is a chronic autoimmune disorder in which the immune system mistakenly attacks the body's tissues, primarily the joints. It causes inflammation in multiple joints, especially in the hands, wrists, and feet that is symmetric on both sides of the body. It leads to joint pain, swelling, stiffness, and potential joint damage over time.

The condition is very rare, affecting 0.04% of the United States population. RA is more common in women than in men, with women being about 2 to 3 times more likely to develop the condition. Hormonal changes, such as those during pregnancy or menopause, may influence RA risk, contributing to its higher prevalence in women. RA usually develops during middle age or later, and risk peaks between age 65 and 80.

Early Signs
Early signs involve changes in the joints and overall changes in the body, including:

Joint Symptoms:

• Pain and Tenderness: Affected joints feel painful or sore, even with light pressure.

• Swelling: Joints may appear puffy or swollen due to inflammation.
• Joint Warmth and Redness: Inflamed joints may feel warm to the touch.
• Morning Stiffness: Difficulty moving joints after waking up, lasting for 30 minutes or more.
• Symmetrical Involvement: Symptoms often occur in the same joints on both sides of the body (e.g., both wrists or both knees).
• Small Joint Involvement: Initial symptoms frequently involve smaller joints, such as fingers, wrists, and toes.

Systemic Symptoms:

• Fatigue: A feeling of persistent tiredness, even without significant physical exertion.
• Fever or Malaise: Low-grade fever and a general sense of feeling unwell.
• Weight Loss: Unexplained weight loss due to systemic inflammation.

When To Seek Care
If you experience persistent joint pain, swelling, or stiffness lasting over a few weeks, consult a healthcare provider. Your provider may order blood tests (e.g., rheumatoid factor, anti-CCP antibodies) and imaging studies (X-rays, ultrasounds, or MRIs) to help confirm the diagnosis.

A primary care physician can perform the initial evaluation to help diagnose patients and then refer them to a rheumatologist. However, since there is a shortage of rheumatologists, primary care physicians often help manage patients. 

This type of arthritis can lead to joint destruction by eating away the cartilage and bone, causing permanent joint deformities, so seeking care as soon as possible is vital. Early detection allows more effective treatment to control inflammation, prevent joint damage, and improve long-term outcomes.


Mai-Trinh T. Pham, MD, Palmetto Family Medicine