The first symptoms of rheumatoid arthritis may be swelling and morning stiffness or just a general aching of the joints. In 90 percent of women, the first areas affected by rheumatoid arthritis are the feet and hands. The disease often affects the wrist and the finger joints closest to the palm, as well as joints in the jaw, neck, shoulders, elbows, hips, knees, ankles and toes. Any joint in the body can be a target.
Inflammation can cause body wide symptoms such as low grade fever, flu like body aches, and a general feeling of not being well. You may also lose your appetite, lose weight, and feel like yo have no energy. Fatigue is a very common symptom of RA and may first overtake you in the afternoon. Fatigue may also be a symptom of anemia, which often accompanies RA. Inflammation can affect the tear producing glands in the eyes and saliva producing glands in the mouth, so you may experience dry eyes and dry mouth. You can have muscle pain and stiffness after sitting or lying in one position for a long time. Depression is also common.
At first, these symptoms may not add up to much. Often a women will complain of joint pain to her doctor, and all that can be seen in a puffiness of the hands, with no obvious redness or warmth. About one-quarter of women with RA develop raised, firm lumps called rheumatoid nodules. Rheumatoid nodules are actually abnormal accumulations of cells, much like the synovial cells that we see accumulating within the joint, but they commonly occur just under the skin. Nodules often appear in an area where there is repeated pressure, such as on the elbows where you lean them on a table, or the finger joints. Because rheumatoid arthritis is a systemic disease, nodules can show up in other places, such as the eye, the heart, the lungs. They can be very destructive, very damaging, interrupting whatever is in their path of growth. And they can be disfiguring and disconcerting to patients.
Up to half of RA patients can develop inflammation in the linings of the chest and lungs, causing pain on taking a deep breath and breathlessness; rheumatoid nodules can also appear in the lung tissues itself, not just the lining. Inflammation can also affect the sac around the heart, producing fever, chest pain, a dry cough and difficulty breathing. Blood vessels can also be inflamed; a common sign is tiny broken blood vessels in the cuticle area of the nail bed.
You may first notice the symptoms of RA during the winter, and symptoms often feel worse during the cold months and improve in warm weather. While RA develops gradually in about 50 percent of women, with symptoms coming and going for months, a more continuous pattern eventually emerges. This disease needs to be diagnosed very quickly and treatment needs to be started quickly. So that increases the importance of having women recognize the signs and symptoms.