May 10 is World Lupus Day. Do you know that lupus and rheumatoid arthritis (RA) share similar symptoms? Both can cause joint pain, swelling, and stiffness. The joints that are most commonly affected – the small joints in the fingers, knees, ankles, and toes – are the same. Both lupus and RA can cause morning stiffness lasting for at least an hour and symptoms usually appear symmetrical (i.e., both wrists are in pain).
Below are symptoms that people with lupus experience and are rare in those with RA:
- Lupus often causes a rash, usually in the shape of a butterfly, that covers the cheeks and bridge of the nose, and can also appear on the body, typically in areas that get sun exposure.
- Lupus is more likely to cause chest pain and shortness of breath. Patients may experience pleurisy, an inflammation of the linings of the lungs and chest that causes chest pain when you take a deep breath. In some cases of RA, heart and lung functions may be affected.
- Lupus can cause kidney problems. Signs of kidney problems include swollen ankles and excessive bubbles in the urine.
Diagnosis of lupus
Because lupus can affect so many different areas of the body, the disease often presents very differently from patient to patient. For this reason, lupus is a disease which is often difficult to diagnose. If you experience three or more warning signs of lupus, you should speak with your doctor about looking into the possibility that you may have lupus.
Warning signs include:
- Swollen or stiff and painful joints
- Loss of appetite and weight loss
- Fatigue and low energy
- Skin rash, especially if brought on by sun exposure
- Ulcers in the mouth and/or nose, usually painless
- Pain in the chest while lying down or taking deep breaths
- Low blood counts, including anemia
While there is no single test for lupus, several blood tests are available which assist doctors in diagnosing lupus. These, combined with other factors such as physical symptoms and sometimes family history, can assist doctors in diagnosing lupus.
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Diagnosis of rheumatoid arthritis
Rheumatoid arthritis has several “hallmark” symptoms when the disease first presents itself. These include:
- Morning stiffness, lasting longer than 30 minutes
- Pain and/or inflammation in the same joints on both sides of your body
- Pain in three or more joints at the same time
- Loss of motion in affected joints
- Severe fatigue
If you experience two or more of these symptoms you should speak with your family physician. Be sure to tell your doctor about any history of rheumatoid arthritis in your family. While there is no known cause of rheumatoid arthritis, research indicates that heredity likely plays a role in that a susceptibility to the disease may be inherited.
If your doctor believes you may have rheumatoid arthritis, you will usually be referred to a rheumatologist-a specialist in the treatment of arthritis. To confirm a diagnosis of rheumatoid arthritis, a doctor may run a number of tests. These may include:
- blood tests, including those to look for abnormal blood antibodies and to get baseline liver and blood counts
- x-ray imaging, to check for joint damage or deterioration
- bone scans are infrequently used but sometimes can help to check for joint inflammation
- joint fluid tests, or arthrocentesis, in which a small amount of joint fluid is extracted using a needle and then analyzed in the laboratory
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