Rheumatoid arthritis occurs as a result of the immune system attacking the synovium (the lining of membranes surrounding joints). This destruction of connective tissue and the synovial membrane results in the following signs and symptoms.
Signs of inflammation, such as heat, swelling, and tenderness, occur symmetrically and commonly affect the small joints of the hands (PIP and MCP) and feet (MTP). Larger joints such as the wrists, elbows, shoulders, knees, hips, ankles, and jaw can also be involved. The joints may become painful, tender, and warm to the touch. This pain can intensify with motion and may not be proportionate to the degree of inflammation.
Morning stiffness may last from 60 minutes to several hours or more, depending on disease activity. Joint stiffness commonly occurs after periods of inactivity.
Rheumatoid nodules are firm bumps of tissue located on extensor surface of joints.
Over time, joint deformities may develop as inflammation and fibrosis of the joint capsules and supporting structures progresses. Common distortions of the hand include ulnar drift, boutonniere, and swan neck deformities.
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