Rheumatoid Arthritis in the Hands: Symptoms and Treatments

Rheumatoid Arthritis (RA) Diagnosis

RA is a problem with your immune system. If you don't diagnose and treat it in time, it could harm your joints. Most people with RA do have some sort of joint damage. Most of it happens in the first 2 years.

Your regular doctor may order blood tests and X-rays to help confirm a diagnosis. Or you may be sent to someone who specializes in diagnosing and treating RA. This type of doctor is called a rheumatologist.

Sometimes, RA can be tough to figure out. Symptoms may come and go, and they aren't the same in all people who have it. But doctors look for specific things:

Joint pain/swelling/stiffness, especially in small joints like your wrists, hands, or feet

Discomfort for at least 6 weeks

Morning stiffness that lasts at least 30 minutes

Fatigue

Loss of appetite

There isn't a single test that gives doctors a clear answer. And in the early stages, RA can resemble other diseases like:

That's why your doctor will rely on many things to help pinpoint the cause of your pain and other symptoms.

Here are some of the things you can expect to happen at your appointment if the doctor thinks you have RA.

Personal and family medical history: Your doctor will ask about your past and your relatives'. If someone in your family tree has RA, you may be more likely to have the disease.

Physical exam: The doctor will check your joints for swelling, tenderness, and range of motion. RA tends to strike several joints.

Antibody blood tests: Doctors look for certain proteins that show up in your blood when you have RA. These proteins mistakenly target healthy cells and kick off the inflammation process. So a high or positive test result means inflammation is in your body.

Rheumatoid factor (RF): high levels (over 20 u/ml)

Anti-CCP (anti-cyclic citrullinated peptide): high levels (over 20 u/ml)

ANA, or antinuclear antibodies: the results are positive or negative

Not all people with RA have these proteins.

Other blood tests: Besides RF and anti-CCP, other blood tests could include:

Complete blood count: It helps your doctor find anemia (low red blood cells), which is common in RA. It looks for four things:

White blood cells 4.8-10.8

Red blood cells 4.7-6.1

Hemoglobin 14.0-18.0

Hematocrit 42-52

Platelets 150-450

Erythrocyte sedimentation rate: This measures how fast your red blood cells clump and fall to the bottom of a glass tube within an hour. Your doctor might call it a sed rate.

Normal ranges are:

Men younger than 50: 0-15 mm/h  

Men older than 50: 0-20 mm/h

Women younger than 50: 0-20 mm/h

Women older than 50: 0-30 mm/h  

C-reactive protein: This test measures levels of a protein your liver makes when inflammation is present. Results vary from person to person and lab to lab, but most of the time a normal result is less than 1.0.

Imaging tests: These can help your doctor judge how severe your disease is and track its progress over time.

X-rays can show whether (and how much) joint damage you have, though damage may not show up early on. 

Magnetic resonance imaging (MRI) and ultrasound give a more detailed picture of your joints. These scans aren't normally used to diagnose RA, but they can help doctors find it early.

When a doctor thinks about how likely you are to have one disease over another, or over several others, this is called a differential diagnosis. There are many conditions your doctor may consider besides RA, and besides other forms of autoimmune arthritis:

Viral arthritis: Rubella, parvovirus, and hepatitis B and C can lead to short-term arthritis symptoms that resemble RA.

Palindromic rheumatism: Periodic joint inflammation that may lead to RA, lupus, and similar diseases

Polymyalgia rheumatica: This is more common over age 50, generally less painful than RA, and associated more with shoulders and hips.

Don't panic if you learn you have rheumatoid arthritis. While there is no cure, people are living better now with RA than ever before. Your doctor will talk to you about all the ways you can treat the disease and manage your symptoms.

Medicines: There are several types: nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and disease-modifying drugs.

Lower the stress on your joints: Lose weight or stay at a healthy weight. Get some rest, but not too much -- moderate activity helps, too. Use canes and walkers to take pressure off your lower body.

Surgery: If you have major joint damage over time, you may want to talk to your doctor about surgery. Total joint replacements of the knee, hip, wrist, and elbow can help. Less serious surgeries may also be good options.

Everything You Need To Know About Rheumatoid Arthritis

HomeHealth

Everything you need to know about rheumatoid arthritis

Dr Rachel Byng-Maddick, consultant rheumatologist at The Lister Hospital (part of HCA Healthcare UK), shares a comprehensive guide to rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune disorder, which means that the body's immune system mistakenly attacks healthy tissues, primarily the synovium; the lining of the membrane that surrounds joints. This immune response triggers inflammation in the synovium, causing it to thicken and swell. As a result, the affected joints can become painful, swollen, and stiff. Over time, this chronic inflammation can lead to joint damage, deformities, and reduced mobility.

"About one per cent of the population in the UK has rheumatoid arthritis"

RA is not rare; in fact, it is the UK's second most common arthritis. About one per cent of the population in the UK has RA, which is more than 450,000 people in the UK. It can affect individuals of any age, but it most commonly develops between the ages of 40 and 60, or a bit older for men. Women are more likely to develop RA than men, with the condition being roughly two to three times more prevalent in females.

Joint pain and stiffness: Persistent joint pain and stiffness, often in multiple joints, are the most common symptoms of rheumatoid arthritis. This pain is typically worse in the morning or after periods of inactivity.

Swelling and redness: Affected joints may become swollen, warm to the touch, and red due to inflammation.

Fatigue: Many people with RA experience severe fatigue, which can significantly impact daily life.

Morning stiffness: Morning stiffness lasting for more than an hour is a common early sign of RA.

Reduced range of motion: As the condition progresses, joint function can become limited, and patients may notice a decreased range of motion.

Joint deformities: Without proper management, RA can cause joint deformities, potentially making it challenging to perform everyday tasks.

Systemic symptoms: RA can also affect other organs and systems, leading to symptoms such as fever, weight loss, and eye inflammation.

Myth: RA only affects older people.

Fact: While RA is more common in middle-aged and older individuals, it can develop at any age, even in children.

Myth: RA is just a normal part of ageing.

Fact: RA is not a natural consequence of ageing. It is an autoimmune disease with specific causes and treatments.

Myth: RA is just joint pain.

Fact: RA is a systemic disease that can affect various organs and systems in the body, not just the joints.

Myth: Weather changes cause RA flare ups.

Fact: While some people with RA may be sensitive to weather changes, there is no conclusive scientific evidence linking weather to RA flare ups.

Myth: RA can be cured with dietary supplements.

Fact: There is no known cure for RA. While some dietary changes and supplements may help manage symptoms, they cannot cure the disease.

Early diagnosis and treatment: Early diagnosis and treatment are crucial in managing RA effectively. Please speak to your GP or a consultant rheumatologist if you suspect you have RA to receive a proper diagnosis and so that you can start treatment promptly.

Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), and biologic agents are commonly prescribed to reduce inflammation and control the disease.

Physical activity: Engage in regular, low-impact exercises like swimming, yoga, or walking to improve joint flexibility and muscle strength. Consult with a physical therapist to develop an exercise plan tailored to your needs.

Rest and joint protection: Balance activity with rest and use assistive devices or joint protection techniques to reduce strain on affected joints during daily tasks.

Pain management: Over-the-counter pain relievers or prescription medications can help alleviate pain. Discuss pain management options with your GP or a qualified medical expert.

Healthy diet: While no specific diet has been found to cure RA, maintaining a balanced and anti-inflammatory diet can help manage symptoms and promote overall health.

Stress management: Stress can exacerbate RA symptoms. It could be worth practicing stress-reduction techniques such as meditation, deep breathing, or mindfulness to improve your wellbeing.

Support and education: Join a support group or seek counselling to cope with the emotional challenges that can come with living with RA. There are lots of helpful resources online and in the media which can help educate people on RA and management of symptoms too.

Regular check-ups: Schedule regular check-ups with your rheumatologist to monitor its progression and adjust your treatment plan as needed.

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