Rheumatoid arthritis(RA), anautoimmune disease, causes distinctjointdamage that can be seen on X-rays.Its symmetrical pattern—meaning it occurs on both sides of the body—helps identify osteoarthritis (OA) from rheumatoid arthritis in knees. Pictures of RA show damage in both knees, where OA typically affects only one.Imaging studies in RA also show joint space narrowing, bone erosion, and joint deformity. This damage occurs from inflammation in thesynoviallining(membrane lining the joints). The inflamed synovium releases enzymes that digest bone and cartilage.This article discusses what RA looks like in different joints. It explains common symptoms and shares pictures of rheumatoid arthritis in knees, hands, feet, shoulders, hips, spine, and other joints.1:43An Overview of Rheumatoid Arthritis
Rheumatoid arthritis(RA), anautoimmune disease, causes distinctjointdamage that can be seen on X-rays.Its symmetrical pattern—meaning it occurs on both sides of the body—helps identify osteoarthritis (OA) from rheumatoid arthritis in knees. Pictures of RA show damage in both knees, where OA typically affects only one.
Imaging studies in RA also show joint space narrowing, bone erosion, and joint deformity. This damage occurs from inflammation in thesynoviallining(membrane lining the joints). The inflamed synovium releases enzymes that digest bone and cartilage.
This article discusses what RA looks like in different joints. It explains common symptoms and shares pictures of rheumatoid arthritis in knees, hands, feet, shoulders, hips, spine, and other joints.
1:43An Overview of Rheumatoid Arthritis
1:43
An Overview of Rheumatoid Arthritis
Rheumatoid Arthritis in Knees
Rheumatoid Arthritis in the Knee
Rheumatoid Arthritis in Hands and WristsAdvanced Rheumatoid ArthritisRheumatoid arthritis most commonly begins in the small joints of the fingers, hands, and wrists.It can damage joints and cause several kinds of hand deformity, such as:Rheumatoid nodules:Firm lumps under the skin near jointsJoint effusion: Abnormal accumulation of fluid inside the jointJoint stiffness: Difficulty moving or impaired range of motionUlnar drift/ulnar deviation: A characteristic deformity in which the fingers appear to lean toward the little fingerContractures: Shortening or hardening of muscles and connective tissues, leading to deformity and rigid jointsWrist subluxation: Partial dislocation (see below)RA Hand Deformity: Is It Inevitable?
Rheumatoid Arthritis in Hands and Wrists
Advanced Rheumatoid Arthritis
Rheumatoid arthritis most commonly begins in the small joints of the fingers, hands, and wrists.It can damage joints and cause several kinds of hand deformity, such as:
RA Hand Deformity: Is It Inevitable?
Rheumatoid Arthritis in Ankles and Feet
andervelden / Getty Images
An estimated 90% of people with RA will havesymptoms in their feetand ankles at some point, and these are among the smaller joints that may be impacted early in the disease progression.
The specific problems attributed to foot and ankle RA depend on the joints involved:
Deformities can make it difficult not only to walk but to wear shoes.
RA in the Foot
Rheumatoid Arthritis in ShouldersAnthony Bradshaw / Getty ImagesTheball-and-socket joint of the shouldermay be an early joint for RA to hit. Research suggests that shoulder impairment may be significant in the first 18 months of disease activity.Symptoms specific to RA in the shoulder include:Lowered shoulder muscle strengthImpaired shoulder and arm movementShoulder painThese symptoms can have a big impact on your activity level and ability to perform daily activities.
Rheumatoid Arthritis in Shoulders
Anthony Bradshaw / Getty Images
Theball-and-socket joint of the shouldermay be an early joint for RA to hit. Research suggests that shoulder impairment may be significant in the first 18 months of disease activity.
Symptoms specific to RA in the shoulder include:
These symptoms can have a big impact on your activity level and ability to perform daily activities.
Rheumatoid Arthritis in Elbowschoja / Getty ImagesStudies say the elbows are involved in between 20% and 65% of rheumatoid arthritis cases.Elbow symptomsyou may experience include:PainSwellingJoint instabilityIf drug treatments and other approaches are unsuccessful at managing elbow symptoms, surgical procedures may be considered.The first surgery is typicallyarthroscopic synovectomy, in which much of the synovium is removed. If that’s unsuccessful, elbow-replacement surgery may be considered.
Rheumatoid Arthritis in Elbows
choja / Getty Images
Studies say the elbows are involved in between 20% and 65% of rheumatoid arthritis cases.Elbow symptomsyou may experience include:
If drug treatments and other approaches are unsuccessful at managing elbow symptoms, surgical procedures may be considered.
The first surgery is typicallyarthroscopic synovectomy, in which much of the synovium is removed. If that’s unsuccessful, elbow-replacement surgery may be considered.
Rheumatoid Arthritis in HipsMedicalRF.com / Getty ImagesRA can impact any joint and the more aggressive it is, the more joints it affects. When it strikes your weight-bearing joints—the hips, knees, and ankles—it can have a huge impact on your mobility.Symptoms specific to RA in the hips include:Aching pain in the groin, buttocks, outer thigh, or kneePain in the hip joint that’s severe enough to make walking difficultPain that’s worse after sitting or sleeping but improves with activityHip replacement surgerycan reduce pain, restore function, and correct joint damage and deformity in people with RA.Joint replacements exist for other joints too, such as the shoulder, wrist, and ankle, but the most common ones are for hips and knees. About 450,000 Americans have a hip replaced each year.
Rheumatoid Arthritis in Hips
MedicalRF.com / Getty Images
RA can impact any joint and the more aggressive it is, the more joints it affects. When it strikes your weight-bearing joints—the hips, knees, and ankles—it can have a huge impact on your mobility.
Symptoms specific to RA in the hips include:
Hip replacement surgerycan reduce pain, restore function, and correct joint damage and deformity in people with RA.
Joint replacements exist for other joints too, such as the shoulder, wrist, and ankle, but the most common ones are for hips and knees. About 450,000 Americans have a hip replaced each year.
Rheumatoid Arthritis and Joint DislocationScience Photo Library / Getty ImagesJoint erosions, which are visible on X-ray, are associated with limited joint mobility and function.As the joint becomes eroded and cartilage is damaged, bone-on-bone contact can be the painful end result.Severe damage to cartilage, tendons, ligaments, and bone can cause joints to become unstable. Joint instability can lead tosubluxation(partial dislocation) or, less often, dislocation.While many joints can become deformed or subluxed due to RA, toes are among the more common ones.The associated pain, damage, and functional limitations often lead to a loss of mobility.People who’ve had RA for more than a decade are at risk of developing a condition calledcervical myelopathy, in which joints of the spine can dislocate and put pressure on the brain stem, spinal cord, and spinal nerve roots.This is an uncommon but serious problem that needs to be corrected with surgery to avoid permanent damage.Rheumatoid Arthritis Healthcare Provider Discussion GuideGet our printable guide for your next healthcare provider’s appointment to help you ask the right questions.Download PDFEmail AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
Rheumatoid Arthritis and Joint Dislocation
Science Photo Library / Getty Images
Joint erosions, which are visible on X-ray, are associated with limited joint mobility and function.As the joint becomes eroded and cartilage is damaged, bone-on-bone contact can be the painful end result.
Severe damage to cartilage, tendons, ligaments, and bone can cause joints to become unstable. Joint instability can lead tosubluxation(partial dislocation) or, less often, dislocation.
While many joints can become deformed or subluxed due to RA, toes are among the more common ones.The associated pain, damage, and functional limitations often lead to a loss of mobility.
People who’ve had RA for more than a decade are at risk of developing a condition calledcervical myelopathy, in which joints of the spine can dislocate and put pressure on the brain stem, spinal cord, and spinal nerve roots.
This is an uncommon but serious problem that needs to be corrected with surgery to avoid permanent damage.
Rheumatoid Arthritis Healthcare Provider Discussion GuideGet our printable guide for your next healthcare provider’s appointment to help you ask the right questions.Download PDFEmail AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
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Rheumatoid Arthritis and Systemic Disease
Rheumatoid arthritis doesn’t only affect the joints. It’s a disease of systemic inflammation that may also affect other parts of your body, including:
Summary
Rheumatoid arthritis causes a distinct pattern of joint damage that can be seen in X-rays. This is typically symmetrical, with the same joints affected on both sides of the body.
RA commonly affects the hands, wrists, elbows, shoulders, knees, hips, ankles, and feet. Imaging studies often show joint erosion and dislocations that cause symptoms of pain, inflammation, and a decreased range of motion.
How Rheumatoid Arthritis Is Diagnosed
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Rheumatoid arthritis.Mohammed A, Alshamarri T, Adeyeye T, Lazariu V, McNutt LA, Carpenter DO.A comparison of risk factors for osteo- and rheumatoid arthritis using NHANES data.Prev Med Rep. 2020;20:101242. doi:10.1016/j.pmedr.2020.101242Johns Hopkins Medicine.RA pathophysiology.Arthritis Foundation.When knee pain may mean arthritis.Goodman SM, Springer B, Guyatt G, et al.2017 American College of Rheumatology/American Association of Hip and Knee Surgeons guideline for the perioperative management of antirheumatic medication in patients with rheumatic diseases undergoing elective total hip or total knee arthroplasty.J Arthroplasty. 2017;32(9):2628–38. doi:10.1016/j.arth.2017.05.001American College of Rheumatology.Joint replacement surgery.American Society for Surgery of the Hand.Rheumatoid arthritis.American Academy of Orthopaedic Surgeons: OrthoInfo.Rheumatoid arthritis of the foot and ankle.Bilberg A, Bremell T, Balogh I, Mannerkorpi K.Significantly impaired shoulder function in the first years of rheumatoid arthritis: a controlled study.Arthritis Res Ther. 2015;17(1):261. doi:10.1186/s13075-015-0777-0Sanchez-Sotelo J.Elbow rheumatoid elbow: surgical treatment options.Curr Rev Musculoskelet Med. 2016;9(2):224–231. doi:10.1007/s12178-016-9328-9American Academy of Orthopaedic Surgeons: OrthoInfo.Inflammatory arthritis of the hip.Simoni P.Optimisation of x-rays imaging techniques for the assessment of joint space.J Belg Soc Radiol. 2018;102(1):23. doi:10.5334/jbsr.1447American Academy of Orthopaedic Surgeons.Rheumatoid arthritis of the foot and ankle.Davies BM, Mowforth OD, Smith EK, Kotter M.Degenerative cervical myelopathy.BMJ. 2018;360:k186. doi:10.1136/bmj.k186Arthritis Foundation.Six ways arthritis can affect your eyes.Rezuș E, Macovei LA, Burlui AM, Cardoneanu A, Rezuș C.Ischemic heart disease and rheumatoid arthritis—two conditions, the same background.Life(Basel). 2021;11(10):1042. doi:10.3390/life11101042Johns Hopkins Medicine.Dental tips for the rheumatoid arthritis patient.Hanaoka H, Kikuchi J, Hiramoto K, Saito S, Kondo Y, Kaneko Y.Decreased chronic kidney disease in rheumatoid arthritis in the era of biologic disease-modifying anti-rheumatic drugs.Clin Kidney J. 2022;15(7):1373–8. doi:10.1093/ckj/sfac036Shaw M, Collins BF, Ho LA, Raghu G.Rheumatoid arthritis-associated lung disease.Eur Respir Rev. 2015;24(135):1-16. doi:10.1183/09059180.00008014Rajeshwari B, Kumar S.Rheumatoid neuropathy: a brief overview.Cureus. 2023;15(1):e34127. doi:10.7759/cureus.34127Arthritis Foundation.How rheumatoid arthritis affects more than joints.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
MedlinePlus.Rheumatoid arthritis.Mohammed A, Alshamarri T, Adeyeye T, Lazariu V, McNutt LA, Carpenter DO.A comparison of risk factors for osteo- and rheumatoid arthritis using NHANES data.Prev Med Rep. 2020;20:101242. doi:10.1016/j.pmedr.2020.101242Johns Hopkins Medicine.RA pathophysiology.Arthritis Foundation.When knee pain may mean arthritis.Goodman SM, Springer B, Guyatt G, et al.2017 American College of Rheumatology/American Association of Hip and Knee Surgeons guideline for the perioperative management of antirheumatic medication in patients with rheumatic diseases undergoing elective total hip or total knee arthroplasty.J Arthroplasty. 2017;32(9):2628–38. doi:10.1016/j.arth.2017.05.001American College of Rheumatology.Joint replacement surgery.American Society for Surgery of the Hand.Rheumatoid arthritis.American Academy of Orthopaedic Surgeons: OrthoInfo.Rheumatoid arthritis of the foot and ankle.Bilberg A, Bremell T, Balogh I, Mannerkorpi K.Significantly impaired shoulder function in the first years of rheumatoid arthritis: a controlled study.Arthritis Res Ther. 2015;17(1):261. doi:10.1186/s13075-015-0777-0Sanchez-Sotelo J.Elbow rheumatoid elbow: surgical treatment options.Curr Rev Musculoskelet Med. 2016;9(2):224–231. doi:10.1007/s12178-016-9328-9American Academy of Orthopaedic Surgeons: OrthoInfo.Inflammatory arthritis of the hip.Simoni P.Optimisation of x-rays imaging techniques for the assessment of joint space.J Belg Soc Radiol. 2018;102(1):23. doi:10.5334/jbsr.1447American Academy of Orthopaedic Surgeons.Rheumatoid arthritis of the foot and ankle.Davies BM, Mowforth OD, Smith EK, Kotter M.Degenerative cervical myelopathy.BMJ. 2018;360:k186. doi:10.1136/bmj.k186Arthritis Foundation.Six ways arthritis can affect your eyes.Rezuș E, Macovei LA, Burlui AM, Cardoneanu A, Rezuș C.Ischemic heart disease and rheumatoid arthritis—two conditions, the same background.Life(Basel). 2021;11(10):1042. doi:10.3390/life11101042Johns Hopkins Medicine.Dental tips for the rheumatoid arthritis patient.Hanaoka H, Kikuchi J, Hiramoto K, Saito S, Kondo Y, Kaneko Y.Decreased chronic kidney disease in rheumatoid arthritis in the era of biologic disease-modifying anti-rheumatic drugs.Clin Kidney J. 2022;15(7):1373–8. doi:10.1093/ckj/sfac036Shaw M, Collins BF, Ho LA, Raghu G.Rheumatoid arthritis-associated lung disease.Eur Respir Rev. 2015;24(135):1-16. doi:10.1183/09059180.00008014Rajeshwari B, Kumar S.Rheumatoid neuropathy: a brief overview.Cureus. 2023;15(1):e34127. doi:10.7759/cureus.34127Arthritis Foundation.How rheumatoid arthritis affects more than joints.
MedlinePlus.Rheumatoid arthritis.
Mohammed A, Alshamarri T, Adeyeye T, Lazariu V, McNutt LA, Carpenter DO.A comparison of risk factors for osteo- and rheumatoid arthritis using NHANES data.Prev Med Rep. 2020;20:101242. doi:10.1016/j.pmedr.2020.101242
Johns Hopkins Medicine.RA pathophysiology.
Arthritis Foundation.When knee pain may mean arthritis.
Goodman SM, Springer B, Guyatt G, et al.2017 American College of Rheumatology/American Association of Hip and Knee Surgeons guideline for the perioperative management of antirheumatic medication in patients with rheumatic diseases undergoing elective total hip or total knee arthroplasty.J Arthroplasty. 2017;32(9):2628–38. doi:10.1016/j.arth.2017.05.001
American College of Rheumatology.Joint replacement surgery.
American Society for Surgery of the Hand.Rheumatoid arthritis.
American Academy of Orthopaedic Surgeons: OrthoInfo.Rheumatoid arthritis of the foot and ankle.
Bilberg A, Bremell T, Balogh I, Mannerkorpi K.Significantly impaired shoulder function in the first years of rheumatoid arthritis: a controlled study.Arthritis Res Ther. 2015;17(1):261. doi:10.1186/s13075-015-0777-0
Sanchez-Sotelo J.Elbow rheumatoid elbow: surgical treatment options.Curr Rev Musculoskelet Med. 2016;9(2):224–231. doi:10.1007/s12178-016-9328-9
American Academy of Orthopaedic Surgeons: OrthoInfo.Inflammatory arthritis of the hip.
Simoni P.Optimisation of x-rays imaging techniques for the assessment of joint space.J Belg Soc Radiol. 2018;102(1):23. doi:10.5334/jbsr.1447
American Academy of Orthopaedic Surgeons.Rheumatoid arthritis of the foot and ankle.
Davies BM, Mowforth OD, Smith EK, Kotter M.Degenerative cervical myelopathy.BMJ. 2018;360:k186. doi:10.1136/bmj.k186
Arthritis Foundation.Six ways arthritis can affect your eyes.
Rezuș E, Macovei LA, Burlui AM, Cardoneanu A, Rezuș C.Ischemic heart disease and rheumatoid arthritis—two conditions, the same background.Life(Basel). 2021;11(10):1042. doi:10.3390/life11101042
Johns Hopkins Medicine.Dental tips for the rheumatoid arthritis patient.
Hanaoka H, Kikuchi J, Hiramoto K, Saito S, Kondo Y, Kaneko Y.Decreased chronic kidney disease in rheumatoid arthritis in the era of biologic disease-modifying anti-rheumatic drugs.Clin Kidney J. 2022;15(7):1373–8. doi:10.1093/ckj/sfac036
Shaw M, Collins BF, Ho LA, Raghu G.Rheumatoid arthritis-associated lung disease.Eur Respir Rev. 2015;24(135):1-16. doi:10.1183/09059180.00008014
Rajeshwari B, Kumar S.Rheumatoid neuropathy: a brief overview.Cureus. 2023;15(1):e34127. doi:10.7759/cureus.34127
Arthritis Foundation.How rheumatoid arthritis affects more than joints.
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