Rheumatoid arthritis (RA) is a chronic autoimmune disease primarily affecting the joints. The immune system mistakenly attacks healthy tissues, leading to inflammation, pain, and swelling, particularly in the lining of the joints. Individuals with RA often experience various symptoms, and finding swollen lymph nodes can cause concern.
Rheumatoid Arthritis and Lymph Node Swelling
Rheumatoid arthritis can lead to swollen lymph nodes, known as lymphadenopathy. This occurs because chronic inflammation in RA activates the immune system. Lymph nodes, part of the lymphatic system, function as filters for inflammatory byproducts and immune cells. When the immune system is highly active, these nodes enlarge to process increased cellular activity.
The enlargement is typically a reactive process, as lymph nodes respond to systemic inflammation from RA. These swollen nodes are often small, soft, and not significantly painful to the touch. They are frequently found in areas close to actively inflamed joints, such as the armpits when hand or wrist joints are affected. In some cases, generalized lymph node swelling can occur, sometimes even before joint symptoms appear, indicating a broader systemic autoimmune process.
Studies show that swollen lymph nodes are a common finding in RA patients, with some research indicating their presence in up to 82% of individuals. Their presence can correlate with higher levels of disease activity, including increased numbers of tender and swollen joints. This suggests lymph node involvement reflects ongoing immune dysregulation associated with RA severity.
Other Reasons for Swollen Lymph Nodes
While rheumatoid arthritis can cause lymph node swelling, many other conditions also lead to this symptom. Swollen lymph nodes are a common immune response to various challenges, and in a person with RA, the cause might not be directly related to their arthritis.
Infections are a frequent cause of enlarged lymph nodes, including common viral infections like colds or flu, or bacterial infections such as strep throat. The nodes often swell in the region draining the infection site, such as neck nodes for a sore throat.
Certain medications for RA or other conditions can cause lymph node swelling as a side effect. For instance, some immunosuppressive drugs, including methotrexate, have been linked to lymphoproliferative disorders that can manifest as swollen lymph nodes. Less commonly, other autoimmune conditions or certain types of cancer, such as lymphoma, can cause lymph nodes to swell. Individuals with RA have a slightly increased risk of developing lymphoma, which is believed to be linked to chronic inflammation.
When to Seek Medical Advice
Given the various potential causes of swollen lymph nodes, it is important to seek medical advice for new or persistent enlargement, especially for individuals with rheumatoid arthritis. A healthcare professional should evaluate any lymph nodes that continue to get bigger or remain swollen for two to four weeks without an apparent reason.
Particular characteristics that warrant medical consultation include nodes that feel hard or rubbery, do not move freely when pushed, or are larger than one centimeter. Accompanying symptoms like unexplained fever, night sweats, or unintentional weight loss also necessitate prompt medical attention. These signs could indicate a more serious underlying condition requiring specific diagnosis and management.
A doctor will typically perform a physical examination, assessing the size, tenderness, consistency, and location of the swollen lymph nodes. They may also inquire about other symptoms and your medical history. Depending on the assessment, further tests such as blood work, imaging studies (ultrasound or CT scans), or a lymph node biopsy may be recommended to determine the exact cause of the swelling.