Since many of the symptoms of rheumatoid arthritis and lupus overlap, it is sometimes difficult to diagnose which disease is afflicting a patient. In fact, many patients go from one doctor to the next without getting a definitive diagnosis. Rheumatoid arthritis and lupus are two different conditions, but both are autoimmune diseases that attack the body in a similar fashion.

Systemic lupus erythematosus (SLE) can affect any organ or organ system and most often results in episodes of inflammation in joints, tendons, and other connective tissues--leading to the achy joints, swelling and stiffness common in sufferers of rheumatoid arthritis.

Other symptoms of lupus vary, and include fever, fatigue, weight loss, joint and muscle pain, swollen glands, hair loss, and nausea and vomiting. One distinguishing symptom of lupus is a 'butterfly-shaped' rash that appears on the cheeks and across the bridge of the nose. This does not show up in every case, but it is a symptom that distinguishes between lupus and rheumatoid arthritis.

The actual reason a person contracts lupus is still not completely understood, but it is believed to involve genetic and environmental factors.

Rheumatoid arthritis affects approximately 1.3 million people in the United States, and is three times more common in women than in men. It causes pain, swelling, stiffness and loss of function in the joints. It is most common in the wrist and fingers, but can affect any joint. It also can affect the body beyond the joints, attacking the eyes, mouth and lungs.

Many of the symptoms of rheumatoid arthritis point to lupus, and many of the symptoms of lupus point to rheumatoid arthritis. It is essential to get a correct diagnosis since untreated lupus can often lead to other serious conditions such as kidney failure and cancer.

Dr. W. Hayes Wilson, Chief of the Division of Rheumatology at Piedmont Hospital in Atlanta and national medical advisor to the Arthritis Foundation, stresses how important it is for the patient to consider themselves their own best advocate. "The patient is in charge of telling the physician all of the important information regarding their symptoms. If the patient has thought through the issues ahead of time and can give their story in a concise and logical manner then the visit will go much more smoothly," he says.  

Dr. Wilson advises arriving to your doctor visit prepared to answer these questions:

  • When did your pain start?
  • What joints are affected?
  • What are the characteristics? Are the joints red, hot, painful or swollen?
  • What makes your pain better? What makes it worse? 
  • Are there medications that have cause adverse reactions in the past? 
  • Are there other medical problems to consider such as kidney disease, liver disease or high blood pressure?

Track Your Symptoms

Before you meet with your doctor, write down in a journal all the symptoms you've experienced in the past month. Note how often you've had these symptoms. Are they constant or do they come and go? Keep track every day.

"Therapeutic decisions have to be made jointly because anything strong enough to help you is strong enough to hurt you.  The risks and benefits have to be honestly assessed and then the ultimate decision is on the part of the patient.  The doctor is the coach, but the patient is the quarterback.  The doctor sends in the play and then the patient has to call the play and execute it," says Dr. Hayes. 


Rheumatoid arthritis. American College of Rheumatology. Accessed November 12, 2009.

Rheumatoid Arthritis. U.S. National Library of Medicine. National Institutes of Health.

Schur PH, et al. Diagnosis and differential diagnosis of systemic lupus erythematosus in adults. Accessed November 12, 2009.

What causes lupus? Lupus Foundation. Accessed November 12, 2009.