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Rheumatoid arthritis commonly affects the small joints of the hands and feet in a symmetrical pattern; however, the large joints such as elbows, shoulders, hips, knees and ankles can also be affected. It can also affect the neck, in particular the first two segments of the cervical spine, which often presents as upper neck pain.
The affected joints are inflamed with swelling, heat and tenderness, and the symptoms are typically worse at rest and early in the morning, which improve with activity. Patients often describe swelling, pain, stiffness and reduced hand grip power and function for a few hours in the morning.
It can affect other organs in the body, so called extra-articular manifestations. The more common problems are dry eyes and dry mouth, but it can also result in inflammation of the lining of the heart (pericarditis) and scarring of the lungs (pulmonary fibrosis).
The clinical course of the disease is generally one of exacerbations and remissions with most patients have a chronic progressive illness.
