Rheumatoid arthritis, or RA, is a chronic disorder of the immune system that causes painful, swollen joints, fever and fatigue. It can be confused with other types of arthritis and other rheumatic disorders. Your doctor might also want to rule out ankylosing spondylitis, a disease causing arthritis-like symptoms primarily in your spine, and systemic lupus erythematosus (SLE), a chronic inflammatory disease that attacks several organs.
Other Types of Arthritis
Several other non-immune forms of arthritis can cause painful, stiff and swollen joints. Osteoarthritis is a common form of arthritis brought on by damage to the joints due to aging. Hands, hips and knees are common sites for osteoarthritis. Septic arthritis occurs in response to an infection within a particular joint. Gout is caused by a build-up of a urate crystals (a natural body by-product) in the joints; it often targets your big toes.
Rheumatoid arthritis differs from all of these conditions because the joint pain is usually symmetrical, involving both hands or both knees, for example. It starts in your 40s, which is earlier than osteoarthritis typically starts. The immune malfunction that causes the joint pain of RA also causes episodes of low fever, a feeling of weakness and fatigue. Unlike osteoarthritis and septic arthritis, RA has periods of remission when the symptoms inexplicably disappear.
Ankylosing Spondylitis
Like RA, ankylosing spondylitis is a chronic autoimmune disorder, sometimes called rheumatoid spondylitis. It primarily causes arthritis-like pain and stiffness of your spine and your hip joints where they meet the spine. In later stages, it might cause a feeling of restriction in your rib cage. Like RA, ankylosing spondylitis can have periods of remission.
RA almost never affects the lower spine and that is one way these conditions are distinguished. RA is more common in women; ankylosing spondylitis is more common in men. RA generally starts in your 40s; ankylosing spondylitis starts between adolescence and age 40.
Systemic Lupus Erythematosus (SLE or Lupus)
SLE is a serious form of lupus, an autoimmune disorder that attacks many organs in your body in addition to your joints. In common with RA, if you have SLE you might experience joint pain, fatigue and fever in episodes (called "flares" in SLE) that come and go. Like RA, SLE is more common in women than in men, but it usually starts earlier than RA, between adolescence and age 40.
In contrast to RA, SLE is more common in African Americans, Asians and Hispanics than in non-Hispanic causcasians. With SLE you often have skin symptoms, including a characteristic rash across your nose and cheeks, hair loss, memory problems, anxiety and depression. People with SLE often experience serious problems with their kidneys, blood vessels, heart and lungs in addition to their joint pain.
