Rheumatoid arthritis commonly presents with which joint involvement pattern?

• A. Symmetric tenderness, swelling, and warmth in multiple joints
• B. Unilateral knee swelling only
• C. Joint redness without swelling
• D. Pain worsened with rest only

Answer: (A)

Symmetric involvement of multiple joints with inflammatory signs is the hallmark pattern of rheumatoid arthritis. This autoimmune process classically targets several joints on both sides of the body, especially the small joints of the hands and wrists, producing tenderness, swelling, and warmth from synovitis. Because many joints are affected at once, the pattern is bilateral and polyarticular rather than focal to a single joint.

This helps distinguish RA from conditions that cause a single joint or an asymmetric pattern, such as gout or osteoarthritis (which often affects joints unevenly and may be more limiting to weight-bearing joints). The presence of swelling and warmth reflects active synovitis, which isn’t typically seen in noninflammatory patterns.

Pain in inflammatory arthritis like RA is usually influenced by rest and activity in a characteristic way—morning stiffness and pain that improve with movement rather than worsening only with rest—so a choice that describes pain worsening with rest alone doesn’t fit the typical RA pattern.