Rheumatoid arthritis: clinical symptoms and signs, diagnosis and treatment

1. Big picture

Rheumatoid arthritis (RA) is the prototype chronic inflammatory autoimmune arthritis. The examiner wants you to recognize this pattern:

Middle-aged woman + symmetric small-joint inflammatory polyarthritis + morning stiffness + metacarpophalangeal/proximal interphalangeal/wrist involvement + anti-CCP positivity ± erosions.

RA is not just “joint pain.” It is a systemic immune disease that can cause irreversible erosions, deformity, disability, cardiovascular risk, lung disease, nodules, vasculitis, anemia, and cervical spine instability.

The treatment principle is:

**Diagnose early → start disease-modifying antirheumatic drug (DMARD) early → treat to remissio