Diagnosis of rheumatoid arthritis

Abstract

The typical clinical presentation, in about three-quarters of patients, is one of an insidious onset of joint tenderness and joint swelling. Joint involvement is classically symmetrical, and the small joints of the hands and feet (the metacarpophalangeal, proximal interphalangeal, and metatarsophalangeal joints) are usually the first to be affected (Suresh 2004). The distal interphalangeal joints are classically spared in rheumatoid arthritis (Figure 2.1). The joints next most commonly involved are the wrists (Boutry et al. 2007). The shoulders and elbows are less commonly affected at the outset, and the hips are rarely involved initially.