RA is caused by a problem with the immune system. It begins to attack healthy tissue. It is not clear what makes this happen. It is most likely a combination of factors in a person's genes and environment. Some causes may be:
Genes—people with RA often have a specific genetic defect
Defects in the immune system—may stop the immune cells from recognizing the body’s own tissues
Infection with specific viruses or bacteria—may start an abnormal immune response
Chemical or hormonal imbalances in the body
RA is more common in women. It often starts in people who are between 30 to 60 years of age.
Pain and swelling usually happens in smaller joints, such as the hands, wrists, and feet. It also affects joints on the same side of the body.
Other problems may be:
Pain, stiffness, and swelling in the morning and after inactivity that lasts more than 30 minutes
Red, warm joints
Deformed, misshapen joints
Lack of energy
Small lumps or nodules under the skin
The doctor will ask about symptoms and past health. A physical exam will be done. There are many diseases that have symptoms that are similar to RA. Tests will be done to rule out other health problems.
Blood tests may be done to look for inflammation and blood proteins linked to RA.
Pictures may be taken to look for tissue swelling and changes in bone. This can be done with:
Aletaha D, Smolen JS. Diagnosis and Management of Rheumatoid Arthritis: A Review. JAMA. 2018 Oct 2;320(13);1360-1372.
Rheumatoid arthritis. Arthritis Foundation website. Available at: http://www.arthritis.org/about-arthritis/types/rheumatoid-arthritis. Accessed October 9, 2020.
Rheumatoid arthritis. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/joint-disorders/rheumatoid-arthritis-ra. Accessed October 9, 2020.
Rheumatoid arthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Rheumatic_Disease/default.asp. Accessed October 9, 2020.
Rheumatoid arthritis (RA). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/rheumatoid-arthritis-ra. Accessed October 9, 2020.
Singh JA, Saag KG, et al. 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Rheumatol. 2016;68(1):1-26.
EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
To send comments or feedback to our Editorial Team regarding the content please email us at firstname.lastname@example.org. Our Health Library Support team will respond to your email request within 2 business days.