My friend who is also a doctor missed her rheumatoid arthritis for some time.
It’s been awhile since med school and she has the same idea about rheumatoid arthritis as so many others.
The picture she remembers involves hands with hand swelling, hand pain, hand arthritis and a degree of deformity.
Note that this does not need to be the case and deformity is clearly a VERY LATE presentation, and one we can and need to avoid (read about the window of opportunity).
She had many months of pain at the balls of the feet. She blamed this on needing to be on her feet a lot at work.
But, in retrospect, the symptoms were inflammatory in nature, with stiffness and a sensation of tightness first thing in the morning. And there was a degree of intermittent swelling.
Mild enough to ignore. Unfortunately.
As this is what most do. Understandably.
Ignore. Explain away. Get on with life.
When the symptoms finally started in her knuckles (her metacarpophalangeal joints), the penny dropped and she referred herself to a rheumatologist.
Rheumatoid Arthritis can start in many joints. The forefeet, typically at the metatarsophalangeal joints, is a common area.
But the initial joints involved could be a shoulder, the wrists, an elbow, the jaw region (temporomandibular joint), the neck, a knee, the ankles or midfeet.
The small joints of the hands are often involved at some stage, but the purpose of this post is to inform you that this doesn’t always have to be the case.
Which joints did your rheumatoid arthritis start in?