Rheumatoid arthritis varies from being an acute disease with fever and sudden disability of many joints to a condition that develops gradually in which the patient may at first notice only stiffness or pain in one joint. Some may have deformity of a joint without ever having felt any pain. Sometimes the first signs of rheumatoid arthritis are fatigue, loss of appetite and loss of weight. Patients complain of numbness and loss of feeling in hands and arms, feet or legs. On getting up in the morning and at the end of the day, the joints feel stiff. When swellings of the joints are noticed the condition is usually well advanced. The knees and the finger joints may be the first to give pain. Practically all the joints may be involved, however, including those of the spine.
Other signs and symptoms of rheumatoid arthritis are known and noticed by many people. The palms and soles are cold and clammy. Sometimes the lymph glands near the joint become swollen. The finger joints nearest to the wrist swell and the fingers pull to the sides in a distortion that gives the hand a “flipper-like” appearance. Because of failure to move and use the muscles around the swollen joint, the tissue breaks down and the area looks thin and wasted.
Rheumatoid arthritis is a condition that comes and goes. Doctors have noticed particularly that it disappears during pregnancy and during jaundice. These facts helped to reveal the specific effects of ACTH and Cortisone upon the disease.
Nodules appear under the skin in about one fifth of the cases of rheumatoid arthritis. These nodules may persist for months or years. Inflammations of the eye and red spots on the skin are also seen often in chronic rheumatoid arthritis.