Clinical Features of Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disease characterized by a polyarticular small joint inflammatory arthritis, as well as diverse extra-articular manifestations. Pre-clinical and early RA may be triggered in extra-articular mucosal sites in a genetically susceptible patient, with subclinical disease findings on imaging and arthralgias heralding the transition to clinical RA. Patients with RA usually have a polyarticular and symmetric inflammatory arthritis involving the small joints of the hands and feet, prolonged morning stiffness, and laboratory findings indicative of systemic inflammation, along with rheumatoid factor (RF) and anti-citrullinated protein antibody (ACPA) positivity. Key extra-articular features of RA that result in a shortened lifespan include interstitial lung disease, cardiovascular disease, and malignancy. As a consequence of these manifestations, RA patients suffer from reduced health-related quality of life, physical function, and survival, although treatment advances have improved many, but not all, of these long-term outcomes.