Rheumatoid Arthritis

Rheumatoid arthritis is an inflammatory and autoimmune disease that causes the immune system to attack the thin membrane that lines the joints. 

Rheumatoid arthritis is progressive and disabling, and can affect the appearance and the function of the hands and other parts of the body through injury to joints and soft tissue structures. It often deforms finger joints and forces the fingers into a bent position, hampering movement. Rheumatoid arthritis affects 1 in every 100 Americans, and it is three times more common in women than in men.

While many patients experience flares followed by periods of remission, sometimes the disease gets steadily more serious.  Deformity, swelling, erosion of the bone and pain are common symptoms. Patients may also form lumps of tissue, called nodules, on bony protrusions, like the elbow. Occasionally, the disease affects other organs of the body, such as the heart, eyes and lungs. Rheumatoid arthritis is a chronic disease, which means there is no cure; however, early and aggressive treatment can put rheumatoid arthritis into remission. 

With decades of experience successfully diagnosing and treating rheumatoid arthritis, the University of Michigan Department of Rheumatology is able to achieve its most important goal:  improving our patients' lives. 

U-M's Rheumatoid Arthritis Research Can Make a Difference

At the University of Michigan Health System, we strive to meet our patients' needs with the use of new techniques and technologies. In fact, University of Michigan researchers have recently discovered the molecular mechanism that triggers rheumatoid arthritis, and we hope to use our discovery to develop cutting-edge treatments for this debilitating disease. [[link to press release]]

Symptoms of Rheumatoid Arthritis

If you experience any of the symptoms of rheumatoid arthritis, it is important to see a rheumatologist to seek an accurate diagnosis and treatment that will slow the progression of the disease. Typical symptoms include:

  • Swelling in and around joints, particularly the hands and feet
  • Pain and stiffness in joints, particularly the hands and feet
  • Warmth in joints
  • Symmetry of the symptoms described above - Rheumatoid arthritis is a symmetrical disease, meaning you will feel symptoms on the same spot on both sides of the body
  • Decreased range of motion
  • Lack of appetite
  • Fatigue
  • Anemia
  • A low-grade fever

Diagnosis of Rheumatoid Arthritis

In addition to a physical exam and medical history, our University of Michigan care team may use the following methods to diagnose for rheumatoid arthritis:

  • Blood tests to identify antibodies and levels of inflammation 
  • X-rays or an MRI
  • Arthrocentesis or arthroscopy: minimally invasive techniques that use pencil-sized instruments and a tiny camera to see inside the body
  • Closed synovial biopsy - a biopsy of the fluid in the joint
  • Synovial fluid analysis
  • Ultrasound

Treatment for Rheumatoid Arthritis


Medications used to treat rheumatoid arthritis include:

  • Non-steroidal anti-inflammatory drugs (NSAIDs), such as Advil, Motrin, Aleve, etc.
  • Corticosteroids such as prednisone
  • Disease-modifying anti-rheumatic drugs (DMARDs), usually methotrexate
  • Biologic agents: a new treatment that can block specific aspects of the immune response

Lifestyle Changes

Lifestyle changes will involve the introduction of a gentle exercise program and education on coping with the limitations caused by this disease. The University of Michigan's team of rheumatologists and therapists will teach you important rheumatoid arthritis life skills such as using aids for your daily activities, splinting and how to avoid damaging your swollen joints.


If your pain continues, or if non-surgical treatment doesn't help, we may suggest surgery to you. Our goals will be to reduce your pain, improve your function, repair damage and improve the appearance of your joints.

Surgical treatment may include removing the swollen tissue from the joints or around the tendons, which may reduce pain and prevent more tendon damage. If the tendon has already been damaged, surgery may be done to repair the damage. Rheumatoid nodules may be surgically removed to improve appearance and comfort. In some cases, the knuckles of the hand may be treated by arthroplasty, a procedure where artificial knuckles (made of silicone rubber or other material) are inserted. This may improve the use of the hand and lessen pain. Surgical procedures performed on the rheumatoid hand and wrist are often complex and may require physical and/or occupational therapy.

Surgical procedures for rheumatoid arthritis often require postoperative therapy. The recovery period varies, depending on the procedure. To reduce the risk of complications, it is essential to continue maximum medical management before and after surgery.

Contact Us / Make an Appointment by calling

  • Orthopaedics at 734-936-5780
  • Rheumatology Services at 888-229-3065

Selecting a health care provider is a very important decision. Because we are highly experienced in treating arthritis and joint inflammation, we would like to help you explore your options. Visit our Contact Us page to see a list of clinics and their contact information. Our staff will be glad to talk with you about how we can help.

Michigan Medicine Comprehensive Hand Center

Our team of specialists at the Comprehensive Hand Center is dedicated to providing comprehensive care for a variety of hand problems. From arthritis injuries, to congenital hand conditions, to the most complex reconstruction, our hand specialists approach each case individually, with a specific plan designed to maximize the restoration of both form and function. Depending on the types of hand conditions our patients face, our physicians will help determine the best therapies or procedures to maximize hand functionality and normal hand appearances. Visit the Comprehensive Hand Center page to learn more about the program and to contact our hand specialists.