Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory disorder that affects nearly 1% of the adult population, with women being affected earlier and more often than men. The disease typically strikes between the third and sixth decades of life, but children and the elderly can be affected as well.

Despite markedly improved and more aggressive medical management, rheumatoid arthritis continues to be, for many, a progressive disease that ultimately leads to significant joint destruction, severe disability, a lower quality of life, and a shorter life expectancy.

Patients with RA typically present with complaints of overall fatigue, morning stiffness that may improve throughout the day, joint swelling, and pain. Patients have serology positive for rheumatoid factor (Anti-IgG IgM antibodies) and antibodies to cyclic citrullinated peptides (CCP) in addition to plain radiographic findings including subchondral bony erosions, periarticular osteopenia, and soft-tissue edema. Synovial hypertrophy precedes joint destruction and can be diagnosed on ultrasound or MRI. Anti-CCP antibodies can be present and detected months to years before the autoimmune attack on the articular surfaces. These antibodies are positive in 50–60% of individuals with RA; antibodies may be present in otherwise seronegative patients (negative serology for rheumatoid factor). Clinical RA will develop in 95–98% of patients with a positive anti-CCP antibody screen. Early diagnosis is paramount as any delay can often lead to irreversible joint destruction and the resultant morbidity.