Are all of the joints affected in the same way by rheumatoid arthritis?

Question: Are all of the joints affected in the same way by rheumatoid arthritis?

In rheumatoid arthritis patients, are all of the joints affected? What causes arthritis to start in the knee for one person and the hand for another. Also, are there two types of arthritis, one characterized by spongy swelling, and the other characterized by rigid contractures?

Answer: The pain and swelling that is associated with rheumatoid arthritis can affect almost all the joints of the body. People may present in different ways. Some may present with involvement of one joint such as the knee. Another might have one hand involved and not the other. Still others may present with a migratory arthritis. For example, the shoulder may be very painful for one day, resolve, and the next day the wrist may be affected.

Most patients eventually develop a somewhat symmetrical arthritis. In other words, if one hand is involved, the other hand will also develop arthritis. Just as the presentation of rheumatoid arthritis may vary between patients, so can the appearance of the arthritis. Some may present with prolonged morning stiffness and pain in the affected joints, but not have any noticeable swelling. Others may have significant swelling.

Many patients with rheumatoid arthritis also develop tendon involvement, especially of the hands, occasionally leading to rupture of tendons and loss of function. No matter how the disease presents, the goal is to prevent joint and tendon damage with early diagnosis and treatment.

Answer provided by Scott J. Zashin, M.D., clinical assistant professor at University of Texas Southwestern Medical School, Division of Rheumatology, in Dallas, Texas. Dr. Zashin is also an attending physician at Presbyterian Hospitals of Dallas and Plano. He is a fellow of the American College of Physicians and the American College of Rheumatology and a member of the American Medical Association. Dr. Zashin is author of Arthritis Without Pain - The Miracle Of Anti-TNF Blockers. The book is a must-have for anyone on one of the biologic drugs (Enbrel, Remicade, Humira) or considering the biologic drugs. Read my review of the book.