Early presentation, symmetrical multi-joint redness, swelling and pain, commonly in the small joints of the extremities; interphalangeal proximal joint pyknosis, swelling and pain in the metacarpophalangeal (metatarsophalangeal), wrist, knee, elbow, ankle and even temporomandibular joints, as well as synovial involvement of the annular joints of the larynx (i.e., phialic joints). Joint stiffness in the morning and gradual reduction in the afternoon is one of the important features of the disease. The longer the morning stiffness, the more serious the disease is, and the more severe the disease is. The middle and late stages of the disease: as the disease develops, it becomes chronic and prolonged, the synovial exudate develops into proliferation, granulomatous lesions, joint movement is limited, and then erodes the bone and cartilage, causing displacement and dislocation of the joint surface, plus the destruction of ligaments, joint capsule and periarticular tissues, making the joint deformed. It is common to have the fingers semi-dislocated in the metacarpophalangeal joint to the lateral side of the little finger, forming an ulnar deviation deformity; the proximal interphalangeal joints of the fingers lose the ability to straighten, and the distal interphalangeal joints are hyperextended and flexed in a gooseneck-like deformity; in severe patients, telescope-like deformity is seen, and the fingers are significantly shortened due to massive resorption of the metacarpophalangeal bones, the skin of the fingers resembles organ-like wrinkles, the finger joints are flaccid and unstable, and the affected fingers can be elongated or shortened in an ancient manner. Telangiectasia. There is another type of deformity called steep valley deformity, in which the dorsal side of the metacarpophalangeal joint is swollen and the interosseous muscles are atrophied. When the patient makes a fist, the dorsal side of the metacarpophalangeal joint is raised like a mountain peak, while the soft tissue between the adjacent fingers is sunken like a valley. The occurrence of joint deformation is not proportional to the duration of the disease. In some patients, multi-joint, irreversible deformities can occur within six months, while in others, the deformation of the joints is less than the former after five years of disease, which is related to various types of the disease such as acute, wavy, and slow relaxation. Other localized joints can often be accompanied by tenosynovitis near the affected joint, carpal tunnel syndrome (tenosynovitis of the flexor muscles of the wrist, which causes compression of the normal nerves in the carpal tunnel, decreased strength and atrophy of the greater interphalangeal muscles) bursitis, popliteal cysts, etc.