Rheumatoid Arthritis

Rheumatoid arthritis (RA) is different from wear-and-tear arthritis. It is a systemic autoimmune disease in which inflammation starts in the synovial lining of joints and may gradually erode cartilage, bone, tendons, and ligaments. RA often begins in the hands, wrists, and feet, but it can also affect the knees, hips, shoulders, and cervical spine.

Orthopedic evaluation is important when RA causes persistent joint swelling, tendon irritation, deformity, instability, or loss of function. At Mountain Spine & Orthopedics, our role is to identify the mechanical damage RA has caused, review imaging, and determine whether bracing, injections, joint-preserving care, or surgery should be considered alongside medical arthritis management.

RA symptoms tend to follow an inflammatory pattern rather than a simple overuse pattern. Patients often notice symmetrical joint pain, swelling, warmth, and stiffness in the same joints on both sides of the body.

• Morning stiffness lasting longer than an hour
• Swollen knuckles, wrists, toes, knees, or ankles
• Fatigue or a general sense of illness during flares
• Loss of grip strength or difficulty with buttons, jars, and writing
• Foot pain at the ball of the foot or changing toe alignment
• Neck pain or neurological symptoms when cervical spine involvement is suspected

Diagnosis starts by separating inflammatory arthritis from osteoarthritis, gout, infection, tendon disease, and nerve-related pain. The clinical pattern matters: symmetrical swelling, prolonged stiffness, and multiple small-joint involvement raise suspicion for RA.

Blood tests such as rheumatoid factor, anti-CCP antibodies, ESR, and CRP may support the diagnosis, while X-rays, ultrasound, and MRI can show synovitis, erosions, tendon irritation, or joint collapse. We offer complimentary MRI reviews and second opinions when imaging is already available.

Medical control of RA inflammation is typically managed with disease-modifying medications such as DMARDs or biologic agents. Orthopedic care focuses on the joints and tendons already affected by inflammation.

Depending on the problem, care may include activity modification, splinting or bracing, image-guided injections for selected painful joints, outside rehabilitation guidance to preserve motion and function, and surgical consultation when tendon rupture, severe deformity, nerve compression, or advanced joint destruction is present. Advanced knee or hip damage may require joint replacement evaluation.