The disease often begins slowly, with symptoms that are seen in many other illnesses:

• Fatigue
• Loss of appetite
• Low fever
• Swollen glands
• Weakness

Eventually, joint pain appears.

• Morning stiffness, which lasts more than 1 hour, is common. Joints can even become warm, tender, and stiff when not used for as little as an hour.
• Joint pain is often felt on both sides of the body.
• The fingers (but not the fingertips), wrists, elbows, shoulders, hips, knees, ankles, toes, jaw, and neck may be affected.
• The joints are often swollen and feel warm and boggy (or spongy) to the touch.
• Over time, joints lose their range of motion and may become deformed.

Other symptoms include:

• Chest pains when taking a breath (pleurisy)
• Eye burning, itching, and discharge
• Nodules under the skin (usually a sign of more severe disease)
• Numbness, tingling, or burning in the hands and feet

Joint destruction may occur within 1-2 years after the disease appears.

A specific blood test is available for diagnosing RA and distinguishing it from other types of arthritis. It is called the anti-CCP antibody test. Other tests that may be done include:

• Complete blood count
• C-reactive protein
• Erythrocyte sedimentation rate
• Joint ultrasound or MRI
• Joint x-rays
• Rheumatoid factor test (positive in about 75% of people with symptoms)
• Synovial fluid analysis

Regular blood or urine tests should be done to determine how well medications are working and whether drugs are causing any side effects.