Joints Most Often Affected by Rheumatoid Arthritis

In This Article

Rheumatoid arthritis (RA) can impact just about any joint, but certain joints are more likely to be involved than others. They include those of the hands and feet, wrists, elbows, shoulders, knees, and ankles. Knowing more about the joints affected by RA can help you recognize early signs and symptoms, and prompt you to get an evaluation. Early diagnosis and treatment are important for safeguarding your health and functionality.

Commonly Affected Joints in Rheumatoid Arthritis

Both small and large joints are frequently targeted by RA. The most commonly affected small joints include the hands, wrists, knees, and feet.

These joints are:

  • Metacarpophalangeal (MCP) joints between the hand and fingers
  • Proximal interphalangeal (PIP) joints, the middle joints of the fingers
  • Radiocarpal joint of the wrist
  • Tibiofemoral joint of the knee
  • Metatarsophalangeal (MTP) joints between the foot and the toes

Doctors use your specific symptoms and pain pattern to differentiate rheumatoid arthritis from similar diseases such as osteoarthritis, psoriatic arthritis, and pseudogout.

Less Commonly Affected Joints in Rheumatoid Arthritis

Joints that are less often targeted by rheumatoid arthritis include:

Rarely Affected Joints in Rheumatoid Arthritis

No joint is 100% immune from RA, but some of them are rarely involved in this disease. These include:

  • Joints of the lumbar spine, where the lower back curves inward
  • Joints of the thoracic spine, the upper and mid-back between the neck and the lumbar region
  • Sacroiliac joints at the base of the spine
  • Costochondral joints in the rib area
  • First carpometacarpal joint at the base of the thumb
  • Distal interphalangeal (DIP) joints at the tips of the fingers

Pain and swelling of the DIP joints is usually associated with osteoarthritis (OA) and not typically caused by rheumatoid arthritis.

Universal Symptoms

Regardless of what joints are affected by RA, you may experience:

  • Joint tenderness and swelling: These are typically among the first signs of the disease.
  • Pain, redness, and warmth at the site of affected joints
  • Symmetrical pattern of symptoms (they effect the same joint on both sides of the body)

You may also experience additional symptoms that are specific to the joints affected.

Seeing Your Doctor About Joint Pain

When you consult your doctor about pain or other issues with your joints, you may only bring what is most bothersome or causing the most interference with usual activities. Don't hesitate to mention other joints, even if symptoms seem mild or unrelated.

Regardless, the doctor will likely perform a thorough joint examination of multiple joints to check for signs of rheumatoid arthritis and similar diseases.

During this exam, your doctor will:

  • Visually inspect your joints for swelling, redness, and deformity
  • Palpate (examine by touch) for pain, warmth, and tenderness
  • Passively move your joints to determine whether your range of motion is normal or abnormal and to determine if movement exacerbates pain
  • Examine your joints for crepitus and joint instability

While it is important for your doctor to accurately note the presence or absence of specific findings during the joint examination, ultrasonography and magnetic resonance imaging (MRI) are more sensitive for detecting synovitis and detailed abnormalities.

Physical signs of rheumatoid arthritis, which would be evident during a joint examination, can be scarce in the early stages of rheumatoid arthritis. That's why a joint examination is only one part of the process.

Your medical history, blood test results, and imaging studies also are necessary aspects when framing an accurate diagnosis.

A Word From Verywell

Most joint pain is from causes other than rheumatoid arthritis. If it turns out you do have RA, it's important to know that treatments have come a long way and may keep you active for a long time. The sooner you get a diagnosis and start the right treatment, the better the prognosis will be.

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Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Rheumatoid Arthritis. Edited by Raashid Luqmani, Theodore Pincus, Maarten Boers. Chapter 3. Diagnosis and clinical features of rheumatoid arthritis. Oxford Rheumatology Library. Oxford University Press. 2010.

  2. Johns Hopkins Arthritis Center. Rheumatoid arthritis signs and symptoms.

Additional Reading
  • Kelley's Textbook of Rheumatology. History and Physical Examination of the Musculoskeletal System. Davis, Moder, Hunder. Part 5. Chapter 40. Published by Elsevier Saunders. Ninth edition.

  • Rheumatoid Arthritis: Early Diagnosis and Treatment. Joint Involvement. Page 32. John J. Cush, M.D., Michael E. Weinblatt, M.D., Arthur Kavanaugh, M.D. Third edition. Published by Professional Communications, Inc.