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Arthritis Arthritis Basics

Pinpointing and Diagnosing Rheumatoid Arthritis

Rheumatoid arthritis (RA) can be a difficult disease to diagnose because it often begins gradually and only a few symptoms may be present in the early stages. Compounding the problem is that many diseases, including other types of arthritis and joint conditions, behave in a similar manner.

The following overview demonstrates how many conditions mimic aspects of rheumatoid arthritis. Understanding their differences helps doctors and patients make educated decisions about diagnosis, treatment and other aspects of disease management.

• Ankylosing spondylitis is a type of arthritis that affects the spine. It may cause pain and stiffness from the neck down to the lower back.
• Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the hand, becomes pinched from swelling of the nerve, tendons or both. The symptoms, which usually start gradually, include tingling or itching and numbness in the palm of the hand and the fingers, especially the thumb, index and middle fingers.
• Fibromyalgia is characterized by aching and pain in muscles, tendons and joints all over the body, but especially along the spine. The body is also sensitive to pressure in specific areas. These are called trigger points.
• Polymyalgia rheumatica is a rare, inflammatory condition that causes pain or aching in the large muscle groups, especially around the shoulders and hips.
• Systemic lupus erythematosus (SLE) is an immune disorder that may cause extreme fatigue and painful or swollen joints. It is identified by the presence of a characteristic rash, often brought on by sun-sensitivity, hair loss and abnormalities in multiple organ systems.
• Bursitis and tendonitis, also known as soft tissue rheumatic syndromes, are associated with pain, swelling or inflammation in the tendons, ligaments and muscles around a joint. Because these structures are near joints, the pain in these areas may be mistaken for arthritis. However, arthritis includes inflammation inside the actual joint, not just around it.
• Tennis elbow, trigger finger and impingement syndrome, which often cause pain in the shoulders and extremities of older adults, are overuse injuries and are commonly mistaken for arthritis.

Differentiating the Signs of Rheumatoid Arthritis
Several types of arthritis are characterized by stiffness of the joints and joint pain, but rheumatoid arthritis is set apart by a few distinguishing features. One is the presence of morning stiffness. It is most pronounced in the morning because fluid in and around the joints redistributes during sleep.

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