Clinical Overview of Rheumatoid Arthritis

Rheumatoid arthritis is the most common chronic inflammatory polyarthritis characteristically involving the small joints of the hands, wrists, and feet in a symmetric distribution. The primary site of pathology is the synovium of diarthrodial joints. Most patients have rheumatoid factor and/or anti-citrullinated protein antibodies in their serum. Extra-articular manifestations may occur and most commonly involve the skin, lungs, heart, eye, and hematologic system. If untreated joint destruction with deformity and significant organ dysfunction leading to disability and death can occur. The etiology is unknown, but recurrent environmental exposures inciting an autoimmune response in a genetically predisposed individual has been proposed. Over the past two decades, there have been several major advancements in the diagnosis and management of this disease.