A telltale sign of rheumatoid arthritis is a symmetrical pattern of joint inflammation. That means joints on both sides of the body, such as the knuckles on both hands or the small joints in both feet, are affected simultaneously.
As the disease progresses, the joints in the shoulders, elbows, hips, jaw and neck may become involved. Eventually, the pain, swelling and resulting joint deformities lead to loss of motion because the joints don't move as well as they used to. It also causes a loss of strength in the muscles that are attached to the affected joints
In about 25 percent of patients, firm lumps called rheumatoid nodules will pop up beneath the skin at various pressure points. They can appear at the elbows, hands, feet and Achilles tendons, or they may show up at the back of the scalp, over a knee or in the lungs. These nodules, which occur in fewer than 10 percent of patients during the first year of disease, are usually not painful. They normally range in size from being as small as a pea to as large as a walnut.
A generalized feeling of aching or stiffness in the joints and muscles is also common. This usually occurs in the morning after sleep or following periods of rest. The morning stiffness may last anywhere from one to two hours or as long as the entire day. This is an important characteristic of active rheumatoid arthritis as most other arthritic diseases do not behave this way.
