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Over time, rheumatoid arthritis can lead to deformities

Rheumatoid arthritis causes pain and potential deformity to the joints.

When attempting to determine the cause of recurring or ongoing joint pain, a few clues can help differentiate rheumatoid arthritis from the more common osteoarthritis. The former occurs when the body’s immune system attacks the joints, whereas the latter is the result of wear and tear on the joints due to activity and age.

“Rheumatoid arthritis usually starts with joint pain and swelling that is worse in the mornings — different from osteoarthritis, which is usually worse at the end of the day after use,” said Amanda Magrini, MD, FAAFP, a family medicine physician at Northern Nevada Medical Group. “It can also have a low-grade fever associated with it.”

In addition, rheumatoid arthritis may be symmetric, meaning it affects the same joints on each side of the body, such as both hands or both knees. When the joint pain is due to osteoarthritis, it tends to show up in fewer spots and without symmetry.

“The primary symptoms of osteoarthritis are joint pain, stiffness and locomotor restriction,” said Bobby Kahlon, MD, a primary care physician with Renown Medical Group. “They usually present in jut one or a few joints in a middle-aged or older person and are not caused by an auto-immune process.”

Without proper medical management, both osteoarthritis and rheumatoid arthritis can lead to the loss of physical function. However, rheumatoid arthritis can eventually lead to bone erosion and joint deformity as well.

“Over time, rheumatoid arthritis can destroy the joints and cause deformity, particularly in the hands. Called swan neck deformity, this is a condition where the fingers actually start to permanently deviate outside of the hand,” Magrini said. “It can cause severe pain and limitations in what someone is able to do because of the destruction of the joints.”

Although there is no specific known cause of rheumatoid arthritis, there are certain risk factors associated with the disease. For example, women are more likely than men to develop the condition. Smoking, obesity, environmental exposures and a family history of the disease are risk factors as well. To diagnose rheumatoid arthritis, doctors may use a combination of physical examination, medical history, blood work and X-rays.

“We perform a thorough medical history, paying particular attention to joint pain, reported swelling and the presence, location and duration of morning stiffness,” Kahlon said.

Neither rheumatoid arthritis or osteoarthritis can be cured, but both conditions should be addressed and managed with proper medical care. In the treatment of rheumatoid arthritis, the goal is to slow down the progression of the disease and, ideally, achieve remission. According to Kahlon, the path toward this goal will depend on the severity of the rheumatoid arthritis and the patient’s response to any previous treatments.

Read on: Over time, rheumatoid arthritis can lead to deformities

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