MCP, wrists, elbows, knees, ankles and MTP are other joints commonly affected where swelling is easily detected. In contrast to gout or septic arthritis, redness of affected joints is not a prominent feature of rheumatoid arthritis. Pain on passive motion is the most sensitive test for joint inflammation. Occasionally inflamed joints will feel warm to the touch. Inflammation, structural deformity, or both may limit the range of motion of the joint.
Permanent deformity is an unwanted result of the inflammatory process.
Persistent tenosynovitis and synovitis leads to the formation of synovial cysts and to displaced or ruptured tendons. Extensor tendon rupture at the dorsum of the hand is a common and disabling problem. Bony erosions seen at the margins of the joint, at the attachment of the synovium, are the hallmark of rheumatoid arthritis. Erosions occur rapidly within the first 2 years of the disease. Renal and liver function should be checked prior to instituting therapy.