The initial symptoms usually appear 1 to 4 weeks after the streptococcal infection has occurred. The actual onset of the disease may be either gradual or sudden. The symptoms vary widely and may be of any degree of severity. The commonest initial complaints are a slight fever, a feeling of tiredness, a vague feeling of pain in the limbs, and nosebleeds. On the other hand, the fever may be quite mild.
Joint pain develops at any stage of the disease and lasts from a few hours to several weeks.
The joints swell and are tender to the touch. The pain and swelling often subside in one group of joints and arise in another. As the pain subsides, the joints return to normal. A rash caused by the fever may appear upon the body. Nodules may be seen or felt under the skin at the elbow, knee, and wrist joints, and along the spine.