Rheumatoid Arthritis In Your Knee: Symptoms, Causes, Diagnosis, Treatments, Surgery

Medically Reviewed by Dr. K on 15 April 2021

Table of Contents :

  1. Rheumatoid Arthritis Of The Knee
  2. Effects of Rheumatoid Arthritis On The Knee
  3. Symptoms of Rheumatoid Arthritis
  4. Diagnosis
  5. Treatments
  6. When To Seek Help
  7. Takeaway

 

Rheumatoid Arthritis of the Knee

Rheumatoid arthritis (RA) is a type of arthritis in which the immune system destroys healthy joints tissues.

It more often impacts the hands and feet, although it may also impact the knees and other joints. RA is always symmetrical. This will, for example, suggest that both knees will be impacted.

Your knees may not exhibit symptoms of RA until much later, even years after symptoms occur.

Untreated RA can contribute to long-term, systemic inflammation, which can lead to joint damage. Up to 60% of people with RA report that if they do not receive treatment, they are not able to carry out daily activities 10 years later due to the symptoms.

Effects Of Rheumatoid Arthritis On The Knee

 

The joint cell lining and capsular tissue that surrounds the joint are attacked and damaged in RA. It’s the same with rheumatoid arthritis in the knees:

 

The synovial membrane that lines the knee joint is the target of immune cells. The cartilage, ligaments, and other tissues of the knee joint are all protected by this membrane. It also produces synovial fluid, which lubricates the joint and allows it to function effortlessly.

The membrane expands and swells. When the tissue is inflamed, it induces pain. The swelling membrane takes up more room in the knee region, limiting knee mobility.

Swelling in the knee joints will weaken the cartilage and ligaments over time. Both assist in knee movement and prevent bones from rubbing against one another.

 

Cartilage wears away when they become weakened, and bones begin to push and rub against one another. This causes pain as well as bone damage.

The likelihood of fracturing or weakening bones is often increased as a result of RA damage. This makes walking or standing without pain or fatigue challenging or unlikely.

Symptoms of Knee Rheumatoid Arthritis

Tenderness, pressure, or stiffness that worsens as you rise, move, or exercise is a common symptom of RA. This is referred to as a flare-up. It can vary in intensity from a slight throbbing pain to a severe, intense pain.

The below are some of the more typical signs of RA in the knees:

  • warmth around the joint
  • stiffness or locking of the joint, especially during mornings or in cold weather 
  • weakness or instability of the joint when putting weight on it
  • difficulty moving or straightening your knee joint
  • creaking, clicking, or popping noises when the joint moves

Other symptoms of RA include the following:

  • fatigue
  • tingling or numbness in the feet or fingers
  • dry mouth 
  • dry eyes
  • eye inflammation
  • loss of appetite 
  • unintentional weight loss

Diagnosis

You’ll get a physical evaluation and the doctor will discuss your personal and family medical history with you. Blood tests can be conducted to determine whether or not you have RA. Blood tests look for:

  • Anaemia (low red blood cell count)
  • Rheumatoid factor (RF), found in about 70% to 80% of people with RA
  • ESR (erythrocyte sedimentation rate). High levels are a sign of inflammation.
  • Anti-CCP: Antibodies to a chemical called CCP
  • High levels of CRP (C-reactive protein)

Additionally, you can undergo an X-ray or, less commonly, an MRI to rule out any joint damage. Your doctor may also take a sample of synovial fluid from your joints to examine it for RA.

Treatments

You will only require over-the-counter (OTC) prescriptions depending on the degree and progression of the RA in your knee.

In severe cases, surgery can regain functionality or relieve pain and discomfort in the knee joint may be required.

The following are non-surgical treatments for RA:

  • Corticosteroids. To further relieve swelling and inflammation, the doctor injects corticosteroids into the knee joint. These injections are just for a short time. You will need them on a daily basis, normally a few times per year.
  • NSAIDs. Nonsteroidal anti-inflammatory medications (NSAIDs), such as naproxen or ibuprofen, are available over-the-counter and can help with discomfort and inflammation. They can be found in virtually any pharmacy or grocery store. Stronger NSAIDs, such as diclofenac gel, can also be prescribed by the doctor.
  • DMARDs. DMARDs (disease-modifying anti-rheumatic drugs) suppress inflammation, reducing symptoms and delaying the progression of RA over time. DMARDs such as hydroxychloroquine and methotrexate are often prescribed.
  • Biologics. Biologics are a form of DMARD that reduces the immune system’s reaction to relieve RA symptoms. Adalimumab and tocilizumab are two popular biologics.

Surgical treatment options for RA include:

  • Damaged ligaments or tendons may be repaired to stabilise the knee joint and reverse inflammation-related injury.
  • Loss of cartilage and scraping of the knee bone may be relieved by reshaping the knee bones or joint tissue (osteotomy).
  • The knee joint may be replaced by an artificial plastic or metal prosthetic joint to improve strength and functionality. This is a very successful procedure: after 20 years, 85 percent of the replacement joints are still functioning well.
  • The synovial membrane around the knee joint may be removed (synovectomy) to relieve discomfort from swelling and activity, although it’s seldom performed nowadays.

Other Treatments

Here are few such proven home and lifestyle treatments for reducing RA symptoms in your knees:

  • Lifestyle changes. To relieve pressure on the knees, try low-impact workouts like swimming or tai chi. To minimise the risk of a flare-up, exercise for shorter amounts of time.
  • Dietary changes. Reduce symptoms by taking an anti-inflammatory diet or taking herbal supplements like glucosamine, fish oil, or turmeric.
  • Home remedies. Apply a warm compress to the joint to help improve movement and reduce swelling, particularly if you’re taking an NSAID or other over-the-counter pain reliever. such as paracetamol.
  • Assistive devices. Customized shoe inserts or insoles are a good option. To make walking easier, you can use a cane or knee braces to relieve pressure on the knee joints.

When To Seek Help

If you have some of the following symptoms relating to your knee joints, see the doctor:

  • inability to walk or do your usual daily activities due to joint pain or stiffness
  • intense pain that keeps you up at night or affects your overall mood or outlook
  • symptoms that interfere with your quality of life, such as keeping you from doing your favorite hobbies or seeing friends and family

If you have excessive knee swelling or hot, painful joints, seek medical attention right away. This could indicate an underlying infection that is causing joint damage.

Takeaway

RA can impact your knees in the same manner it affects every other joint in the body, causing discomfort, weakness, and swelling that can interfere with your daily activities.

The key is to get help as soon as possible. Over time, the joint may be weakened, limiting the mobility and finding it difficult to walk or stand.

If the discomfort is affecting the quality of life and making it difficult to do basic activities involving your knees, see your doctor.

Sources

Referenced on 13/4/2021

  1. Arthritis by the numbers. (2018).
    arthritis.org/Documents/Sections/About-Arthritis/arthritis-facts-stats-figures.pdf
  2. Arthritis of the knee. (2014).
    orthoinfo.aaos.org/en/diseases–conditions/arthritis-of-the-knee/
  3. Mayo Clinic Staff. (2019). Rheumatoid arthritis.
    mayoclinic.org/diseases-conditions/rheumatoid-arthritis/symptoms-causes/syc-20353648
  4. Ruffing V, et al. (n.d.). Rheumatoid arthritis signs and symptoms.
    hopkinsarthritis.org/arthritis-info/rheumatoid-arthritis/ra-symptoms/
  5. Total knee replacement. (2016).
    my.clevelandclinic.org/health/articles/total-knee-replacement-surgery
  6. Watson S. (2016). Understanding RA flares.
    arthritis.org/living-with-arthritis/pain-management/flares/ra-flare-up-severity.php
  7. National Institute of Arthritis and Musculoskeletal and Skin Diseases: “What are Knee Problems?"  “Living with Arthritis," “Rheumatoid Arthritis."
  8. National Institutes of Health: “X-Plain Rheumatoid Arthritis."
  9. Arthritis Foundation: “Rheumatoid Arthritis Resources."
  10. Arthritis Today: “How is Rheumatoid Diagnosed?"
  11. American College of Rheumatology: “Rheumatoid Arthritis,"  “Joint Surgery."
  12. https://www.webmd.com/rheumatoid-arthritis/knee-ra-rheumatoid-arthritis-of-the-knee 
  13. https://www.healthline.com/health/advancing-rheumatoid-arthritis/rheumatoid-arthritis-knee#when-to-see-a-doctor

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