Rheumatic & autoimmune conditions treated

Early signs

• Morning stiffness in the hands lasting longer than 30–60 minutes
• Swelling of the small joints of fingers (MCP, PIP) and toes (MTP), usually on both sides
• Difficulty making a full fist, opening jars, or wringing out clothes

Early signs

• Aching and stiffness in both shoulders, upper arms, neck, hips and thighs
• Severe morning stiffness lasting more than 45 minutes
• Difficulty raising the arms to comb hair, or getting out of bed and low chairs

Early signs

• A malar or butterfly rash across the cheeks and bridge of the nose, sparing the nasolabial folds
• Rash or flare that appears after sun exposure (photosensitivity)
• Painful joints — typically hands, wrists and knees — often without visible swelling

Early signs

• Gritty, burning eyes as if sand is trapped under the lids
• Dry mouth needing water to swallow dry food such as chapati or biscuits
• Rapidly increasing dental cavities and gum disease

Early signs

• Raynaud's phenomenon — fingers turning white, then blue, then red with cold or stress
• Puffy, swollen fingers that later become tight and shiny
• Difficulty making a fist or opening the mouth fully

Early signs

• Difficulty climbing stairs, rising from a squat or from a low chair
• Trouble lifting arms to comb hair or reach an overhead shelf
• Neck weakness, the head feels heavy, difficulty lifting it off the pillow

Early signs

• Sharply demarcated colour change of fingers with cold exposure
• Numbness or pins and needles during an attack
• Throbbing and redness as circulation returns

Early signs

• Deep vein thrombosis, a painful, swollen calf
• Stroke or transient ischaemic attack in someone under 50 without usual risk factors
• Recurrent early miscarriage, or fetal loss after ten weeks

Early signs

• Low back and buttock pain before age 40, developing gradually over months
• Pain and stiffness worst on waking or after prolonged sitting; better after a hot shower or activity
• Alternating buttock pain that shifts from side to side

Early signs

• Joint pain and swelling in someone with psoriasis, however mild the skin disease
• Sausage-like swelling of an entire finger or toe (dactylitis)
• Pain at the heel, Achilles tendon or elbow insertion (enthesitis)

Early signs

• Sudden painful swelling of a knee, ankle or foot joint, one to four weeks after a gut or urinary infection
• Asymmetric involvement of a few lower-limb joints
• Heel pain from Achilles or plantar fascia enthesitis

Early signs

• Sudden severe joint pain, often waking the patient in the early hours
• Redness, warmth and shiny skin over the joint, peaking within 12–24 hours
• Extreme tenderness — even light touch or bedding is unbearable

Early signs

• Sudden swelling, warmth and severe pain in the knee or wrist
• An attack developing over 12–36 hours, often after surgery, illness or dehydration
• Low-grade fever accompanying the attack

Early signs

• Pain that worsens with activity and eases with rest, the opposite pattern to inflammatory arthritis
• Morning stiffness lasting under 30 minutes
• Difficulty with stairs, squatting, getting up from the floor or from a low chair

Early signs

• Usually completely silent — no pain, no warning
• Gradual loss of height, more than 3 cm from peak adult height
• Increasing forward stoop of the upper back (kyphosis)

Early signs

• Widespread pain above and below the waist, on both sides, for more than three months
• Non-restorative sleep — waking tired regardless of hours slept
• Profound fatigue, often worse than the pain itself

Early signs

• Persistent fever, night sweats, weight loss and fatigue with no infective cause found
• New severe headache with scalp tenderness, or jaw pain while chewing (giant cell arteritis)
• Arm claudication, absent or unequal pulses, or a blood pressure difference between arms (Takayasu)