Rheumatoid arthritis (RA) and lupus are both chronic conditions that cause joint pain and inflammation. They are both systemic diseases, which means they can cause general symptoms such as fatigue, and they can affect various organs in the body. Rheumatoid arthritis and lupus are both autoimmune diseases in which the body's immune system attacks itself. However, there are differences between RA and lupus, which can aid in making an accurate diagnosis and choosing the right treatment approach.
Examine the Symptoms
Step 1
Look for joint swelling. Rheumatoid arthritis primarily attacks the synovial lining of the joints; in the initial stages, it tends to affect small joints in the hands, feet and wrists. This disease not only causes pain, but swelling as well. Over time, the affected joint(s) may become damaged and disfigured due to the constant swelling. Lupus can also cause joint pain, however, the Lupus Foundation of America states there is usually no joint swelling or only periodic swelling. Due to this, individuals with lupus do not usually need to undergo joint-replacement surgery as do some patients with advanced RA. In general, lupus causes less physical damage to the joint, yet it causes more severe pain. The joint pain associated with RA may be less then with lupus, but RA causes more joint destruction. In some cases, these two conditions can occur at the same time, which requires standard RA treatment to help prevent joint destruction.
Step 2
Be aware of any skin rashes. Rheumatoid arthritis rarely causes skin rashes. In contrast, rashes can be common with lupus. Patients with lupus may develop a butterfly-shaped rash on the face called a malar rash. This rash tends to cover the bridge of the nose and the cheeks. This may or may not be accompanied by general skin lesions that become worse when exposed to the sun.
Step 3
Take note of any kidney problems. Although rheumatoid arthritis can affect many systems of the body, lupus is more prone to causing kidney damage and failure. However, this can be monitored, and if caught early enough through blood and urine tests, kidney damage can be successfully managed. According to the Hospital for Special Surgery, this complication occurs because the antibodies that are active in someone with lupus deposit themselves in the kidneys and cause inflammation.
Step 4
Get blood tests and a physical examination. Blood tests alone cannot confirm a diagnosis of either rheumatoid arthritis or lupus. Blood tests must be combined with a physical exam and review of the history of symptoms as well as other scans and tests. In general, blood tests for both of these conditions will show over-activity of the immune system. In approximately 70 to 80 percent of people with rheumatoid arthritis, a blood test is positive for the presence of a rheumatoid factor, or RF, which is an indication of how severe the disease will be. In contrast, blood tests for those with lupus may need to be combined with a urinalysis to detect the presence of protein in the blood cells and urine. If protein is found, it may be a sign of lupus-related kidney disease.
Tips and Warnings
- It may be helpful to keep a diary of symptoms, including what makes them better and what makes them worse. This can then be shared with a health-care professional to aid in making a correct diagnosis. This is important as both of these conditions can go through periods of flares, followed by periods that are symptom-free.
- Never try to self-diagnose. There are many other conditions that share the same symptoms of rheumatoid arthritis and lupus. For the best possible outcome, be sure to seek medical attention at the first sign of symptoms. Most diseases are easier to treat if caught in the early stages.
