What are some systemic and extra-joint manifestations of rheumatoid arthritis?

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kipling2448 eNotes educator| Certified Educator

Rheumatoid arthritis is a painful, crippling disorder that affects the joints but can also have systemic symptoms that affect the entire body.  By definition, those symptoms that manifest themselves beyond the joints are considered “systemic,” and the symptoms involve inflammation of the eyes, lungs, heart, blood vessels, and the muscles directly connected to the affected joints.   Each of these symptoms are intensely painful and can adversely affect an individual’s ability to breathe, as would be expected from any disease that causes inflammation of the central organs of the respiratory and circulatory systems.   Systemic manifestations of rheumatoid arthritis can be expected to shorten the normal life span of those affected.

Extra-joint manifestations of rheumatoid arthritis – more commonly called extra-articular manifestations – are also extremely serious, and extremely debilitating.  As mentioned with regard to systemic manifestations of the disease, extra-articular symptoms include cardiovascular disease, cardiomyopathy, arrhythmia, weakening of heart valves, and eventual heart failure.  Pericarditis, inflammation of the sac (the pericardium) surrounding the heart, is the most common extra-articular manifestation of rheumatoid arthritis.  The cardiovascular symptoms of rheumatoid arthritis tend to manifest themselves in increasingly and easily exhausted patients who become progressively weaker due to the inflammation of the pericardium.  The chest pain the patient feels when such inflammation occurs is usually the earliest sign that there is a problem, but development of breathing problems, for example, shortness of breath, is also an important indicator of cardiovascular problems that can be attributable to the arthritis.

Development of cardiomyopathy, or a progressive weakening of the heart, which can be associated with rheumatoid arthritis, manifests itself in shortness of breath, swelling of legs and feet, irregular heartbeat, dizziness or disorientation, and fatigue. 

As can be seen, the effects of rheumatoid arthritis on the human body are extremely serious and life-threatening.  Outward manifestations can be numerous and invariably involve considerable discomfort for affected individuals.  Prompt diagnosis and treatment are required.

[For a more detailed, technical discussion, see www.rheumatology.oxfordjournals.org/content/45/suppl_4/iv4.full]

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