Health Questions and Answers

Question: Which joints are most commonly involved in RA?


RA is a symmetric polyarthropathy that can involve almost any diarthrodial joint. The hands and wrists are involved in over 90% of patients. About one half of patients with RA develop x-ray evidence of hip involvement. Foot and ankle disease can have a major impact on function, although ankle involvement is rare in the absence of MTP involvement. Palpable swelling at the radiohumeral joint, along with incomplete extension, marks elbow involvement. Nodules and concomitant swelling of the olecranon bursae also may suggest elbow disease. Knee involvement is common. Other joints involved include the shoulders, temporomandibular joints, cricoarytenoid joints (sometimes explaining why patients commonly have “sore throats” without signs of pharyngitis), and ossicles of the ears (which may be in part responsible for some hearing loss).

Reference:  Sheon RP, et al (eds): Soft Tissue Rheumatic Pain: Recognition, Management and Prevention, 3rd ed. Philadelphia, Lippincott Williams & Wilkins, 1996.

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