Painful and swollen joints in the hands are not necessarily rheumatoid arthritis, but need to be combined with other symptoms and auxiliary tests for a comprehensive judgment. Besides rheumatoid arthritis, there are also possibilities of rheumatoid arthritis, osteoarthritis, trauma or cold. If there is pain and swelling in the hand joints, you need to go to the hospital to improve the relevant examination to see what causes the injury, early diagnosis and early treatment.1. Rheumatoid arthritis: Infection with hemolytic streptococcus may cause rheumatoid arthritis, which occurs in large joints such as the knee and shoulder joints. The initial manifestation is joint swelling and pain, and the development of the disease will also cause dysfunction at the site of the lesion. But rheumatoid arthritis is less likely to occur in small joints such as hand joints; 2. Rheumatoid arthritis: If the hand joints are symmetrically painful and swollen, rheumatoid arthritis should be considered. Rheumatoid arthritis early manifestations of hand joint weakness, swelling and diffuse muscle pain, morning stiffness of the hand joints, limited movement is also one of the main features, there may be muscle atrophy around the affected joints; 3, gouty arthritis: hand joint pain and swelling caused by gout, mainly due to the deposition of uric acid crystals in the hand joints caused by the onset of redness and swelling of the hand joints and intolerable severe pain; 4, osteoarthritis 4, osteoarthritis: osteoarthritis of the fingers due to osteophytes and other causes, often in the distal interphalangeal joints nodules, generally painless, after exertion or cold may cause painful swelling; 5, trauma or cold: local extrusion caused by the surrounding soft tissue damage, or long-term soaking in cold water, may lead to joint cavity fluid inflammation, the hand joints will be painful swelling.