What Are the 4 Stages of Rheumatoid Arthritis?

Written by Ally Streelman

NowRx Pharmacy

What are the 4 Stages of Rheumatoid Arthritis?

Rheumatoid Arthritis, or RA, is a painful condition that affects the joints. With an autoimmune disease, such as RA, the body’s immune system attacks healthy cells. In this case, it attacks cells at the joints and causes inflammation

There are four stages of rheumatoid arthritis. At first, inflammation leads to joint swelling, stiffness, and pain. As the disease progresses, it damages the joint tissues until there is no tissue left. But with modern treatment options, the progression into later stages is avoidable. 

What are the 4 stages of rheumatoid arthritis and how is it diagnosed? We’ll cover these questions below so you can catch RA early. 

Early Signs of Rheumatoid Arthritis 

If you seek treatment when you begin to notice the early signs of rheumatoid arthritis, you can prevent its progression and loss of movement in the future. If the disease progresses without intervention, though, RA could permanently damage joints. Early signs of rheumatoid arthritis include mainly joint pain and joint stiffness.

These symptoms usually occur at multiple joints at the same time. RA most commonly affects joints in the hands, knees, and ankles.  

rheumatoid arthritis vs healthy joint infographic

What does rheumatoid arthritis feel like?

Joint pain is not abnormal. Many people experience pain in their joints every now and then with age and after rigorous exercise or activity. Joint pain can also be a symptom of other types of arthritis, such as psoriatic arthritis. With RA, though, the pain tends to be symmetrical and tends to affect smaller joints. For instance, one might experience pain in the fingers on both hands, or in both the right and left ankles. 

In the early stages, pain and stiffness also tend to be most prominent upon waking and may fade with movement. In later stages, joint pain becomes much more severe. 

Unusual symptoms of rheumatoid arthritis

Most people experience the usual stiffness and swelling, but there are some unusual symptoms of rheumatoid arthritis. These include a skin rash, eye pain, and difficulty breathing. These symptoms are signs of inflammation elsewhere in the body. People may also get rheumatoid nodules, which are lumps on the elbows.

How is Rheumatoid Arthritis diagnosed?

Rheumatoid arthritis is diagnosed with the help of a rheumatologist—a specialist in the disease. A rheumatologist will run tests, perform x-rays and ultrasounds, and discuss symptoms to diagnose RA. After diagnosing the condition and stage, they can also provide treatment plans. 

If you think you may have rheumatoid arthritis, the sooner you can see a specialist, the better. Early treatment is key to slowing the progression of the disease.  

Is rheumatoid arthritis genetic?

It is true that people with specific genes are more likely to develop RA. These genes are called HLA class II genotypes. However, lifestyle factors do play a role. For instance, a person with the genes who smokes or is obese is more at risk than someone with the genes who maintains a healthier lifestyle.

The Stages of Rheumatoid Arthritis

There are four stages of RA, which escalate from minor to severe. If you don’t have symptoms but are at risk of developing rheumatoid arthritis, there are ways to help prevent its onset

Stage 1: Synovitis

rheumatoid arthritis stage 1 showing synovitis

The first stage is early RA or synovitis. This is when you might start to experience swelling or pain in the joints of your hands, knees, ankles, or feet. You may not experience this pain all of the time, though. Pay close attention to how you feel first thing in the morning as this is typically when the pain and stiffness are most prevalent. 

Stage 2: Pannus

rheumatoid arthritis stage 2 showing pannus

During the second stage of RA, symptoms are more noticeable and the condition may be easier to diagnose. The joints will begin to swell and antibodies may show up in blood tests. This is usually the time when most patients seek a rheumatologist. 

This is also the time when the joint tissue starts to show signs of damage. As inflammation continues, the tissue will continue to wear away, and the disease will progress to stage three. 

Stage 3: Fibrous Ankylosis

rheumatoid arthritis stage 3 showing fibrous ankylosis

During stage three of RA, the joint tissue will continue to disintegrate. The bones where the joints once were will rub against one another and begin to fuse together. When this occurs, movement becomes less possible and more painful. Thus, symptoms will be quite severe. Not only will movement be extremely limited, but the joints will appear misshapen. 

Stage 4: Bony Ankylosis

rheumatoid arthritis stage 4 showing bony ankylosis

In the final stage of RA, the bones completely fuse together and the joints are no more. With the absence of joints, there is an absence of pain as well. However, as you might expect, the range of motion in affected joints is zero. For affected finger joints, stage four RA can make it extremely difficult to perform simple tasks. 

The Importance of Seeking Treatment

While rheumatoid arthritis used to progress without much intervention, modern medicine has made it possible to avoid later stages. In order to do so, it’s critical to seek a diagnosis and treatment as soon as possible. If you’re experiencing early signs of rheumatoid arthritis, talk to your doctor and ask them to refer you to a specialist. 

With treatment, those with RA can ease symptoms, slow progression, and enjoy a life full of movement. 

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