	Chronic, erosive arthritis.
Etiology
Epidemiology	F>M. Risk factors: smoking
Clinical presentation	Active symmetrical arthritis >6/52 Rheumatoid nodules - over extensor surfaces of tendons, not necessarily over a joint. More likely if many joints involved. See hand signs below
Pathogenesis
Diagnostic investigations	RF, anti-CCP
Management	NSAIDs for symptomatic relief 1st line: conventional DMARDs e.g. MTX, leflunomide, SSZ Steroids may be used short-term to manage flares

non-joint signs

Haem: normocytic anaemia, thrombocytopenia; hepatosplenomegaly (Felty’s syndrome → ↓ neutrophils)
Resp: Pulmonary fibrosis/interstitial lung disease (most common), exudative pleural effusions, Caplan's syndrome, empyema
Skin: rheumatoid nodules (pics), vasculitis
Cardio: ↑ risk MI
Renal: ↑ risk amyloid deposition
Ophthal: scleromalacia perforans; sicca

classic hand signs

ulnar deviation at MCPJs
Swan-neck deformity = PIPJ hyperextension, DIPJ flexion
Boutonniere's deformity = PIPJ hyperflexion, DIPJ hyperextension
- Yes swan-neck and boutonniere are complete opposites
Z deformity of thumb