Rheumatoid arthritis (RA) is a symmetrical, multi-joint involvement as the main clinical manifestation of the disease, its joints are chronic, progressive, destructive involvement, if not properly treated, the disease will gradually develop, eventually leading to joint deformity, loss of function, is one of the major disabling diseases in China, bringing a heavy burden to the patient’s family and society. The etiology and pathogenesis of rheumatoid arthritis is not fully understood, but the current consensus view is that it is the result of a combination of genetic background, environmental factors and immune disorders. The clinical manifestations of rheumatoid arthritis can occur at any age, the prevalence in the population is about 0.3%, foreign reports rheumatoid arthritis high incidence age in 50-60 years, domestic epidemiological survey results show that the peak age of female patients in 35-44 years, male patients in 55-64 years. Most patients with rheumatoid arthritis have an insidious, subacute onset and may have prodromal symptoms such as low-grade fever, general malaise, fatigue and weight loss for several weeks before the onset of significant joint symptoms, followed by the gradual onset of typical joint symptoms. The clinical manifestation of rheumatoid arthritis varies greatly among individuals and has a heterogeneous onset. Most cases have chronic, progressive and recurrent attacks, which can eventually lead to destruction of joint structures and thus affect joint function. 1, morning stiffness phenomenon Morning stiffness refers to the discomfort of stiffness in the joints after waking up in the morning, and the symptoms are reduced after activity, and the duration of activity is called the duration of morning stiffness. In fact, morning stiffness does not only appear in the morning when you wake up, but also after a long period of immobility. The mechanism is that after a long period of rest, a large amount of joint fluid accumulates in the joint capsule in arthritic joints, resulting in unfavorable joint movement. Morning stiffness can also occur in other arthritic conditions. Morning stiffness is more prominent in inflammatory arthritis, represented by rheumatoid arthritis. Morning stiffness occurs in more than 95% of patients with rheumatoid arthritis. The duration of morning stiffness can predict the severity of joint inflammation and is often used as one of the clinical indicators to observe the activity of rheumatoid arthritis. 2. Swelling and pressure pain of joints Joint pain/pressure is the earliest symptom, and pigmentation of the skin of the affected joints may occur. Joint swelling is caused by fluid accumulation in the joint cavity or inflammation of the soft tissues around the joint, and is manifested by localized swelling of the joint and increased local skin temperature. It is important to note that joint pain is not the same as arthritis, but joint swelling can only be called arthritis. 3. Joint deformity is seen in patients in the middle and late stages, mainly due to bone destruction (or/and) damage to the tendons and ligaments around the joints so that the joints cannot be maintained in a normal position, resulting in different degrees of joint deformity, the most common being subluxation of the metacarpophalangeal joint and ulnar deviation of the fingers, hyperextension of the proximal interphalangeal joint, making the hand “swan neck-like “The most common deformities are subluxation of the metacarpophalangeal joint and ulnar deviation of the fingers. In severe cases, the joints become fibrous or bony ankylosis, making life unmanageable and seriously affecting the patient’s quality of life. Rheumatoid arthritis “gooseneck” deformity 4, other special joint involvement of clinical manifestations Rheumatoid arthritis in addition to the involvement of common peripheral joints, can also involve some rare joints, such as: temporomandibular joint is the most common involvement of special joints, about 25% of patients with rheumatoid arthritis have temporomandibular joint involvement, manifested as temporomandibular joint pain. In severe cases, mouth opening may be limited. （The atlantoaxial joint is also a special joint involved in rheumatoid joints, with clinical manifestations of neck pain, restricted movement, and even spinal cord compression due to cervical subluxation, resulting in numbness of the fingertips, which can lead to high paraplegia in severe cases.