In clinic, many people with rheumatoid arthritis first notice subtle changes—not sudden, severe pain—but reduced dexterity in the hands. For example:
In clinic, people with gout often present with sudden, severe joint pain. A single joint may become clearly red, swollen, hot and painful within a short period of time.
In clinic, many people with polymyositis or dermatomyositis do not first seek help because of pain.
HK Clinic 
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