- 🔬Pathophysiology
- Autoimmune synovial inflammation (pannus) → symmetric erosive polyarthritis.
- 🩺Signs & Symptoms
- Symmetric small-joint pain/swelling (MCP, PIP, wrists), morning stiffness >1 h, fatigue; spares the DIP.
- 🎯Gold Standard Diagnosis
- No gold-standard test: clinical dx + RF/anti-CCP (anti-CCP more specific), ↑ESR/CRP, erosions
- 💊First-line Treatment
- Early DMARD — methotrexate monotherapy first-line (moderate-high); biologic if not at target; steroids not routine.