Most patients with rheumatoid arthritis have an insidious onset and gradually develop swelling and stiffness in the proximal interphalangeal joints, metacarpophalangeal joints, wrist joints and other small joints of the extremities over a period of weeks or months. A small number of patients may have an acute onset within a few days after being stimulated by external factors such as infection, overexertion, surgery, childbirth, etc. The onset of the disease is often accompanied by general malaise, loss of appetite, weight loss, etc. Some patients may have a low-grade fever. In addition to the external joint manifestations, the lung, heart, nervous system, bone marrow and other organs may also be involved.