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* * Grassi W, De Angelis R, Lamanna G, Cervini C. The clinical features of rheumatoid arthritis.Eur J Radiol. 1998;27(suppl 1):S18-S24. Slide 2 Notes. Rheumatoid Arthritis: Overview RA is a chronic inflammatory disease that most frequently affects the joints primarily but also other body systems. The cause of RA is unknown, but much progress in elucidating its pathogenesis has been made in the past decade. It is likely that many pathogenetic and environmental mechanisms are involved. The clinical course of RA is highly variable and unpredictable for an individual. Typically, joint symptoms progress slowly. The disease is characterized by progressive destruction of the synovial joints. This damage causes loss of cartilage and bone. The radiological signs are loss of joint space and bone density. In addition to joint destruction, RA also causes ligaments and tendons to be destroyed. Loss of joint function eventually occurs as a result of destruction of bone and cartilage. Patients also experience reduced quality of life as a result of their loss of function. In addition, RA also may be associated with increased mortality and premature death. * * Slide 13 Notes. Diagnosis of Rheumatoid Arthritis: American College of Rheumatology Criteria The revised clinical criteria for the diagnosis of rheumatoid arthritis published in 1987 by the American College of Rheumatology are generally accepted today. At least 4 of the following 7 criteria must be present, with the first 4 being present for 6 weeks or more. Morning stiffness in and around the joints lasting more than 1 hour before maximal improvement. Physician-observed simultaneous soft tissue swelling (arthritis) or fluid present in 3 or more of 14 joints: right or left proximal interphalangeal (PIP), metacarpophalangeal (MCP), wrist, elbow, knee, ankle, or metatarsophalangeal (MTP). Soft tissue swelling in at least one area of the wrist; MCP, or PIP joint. Simultaneous involvement of the same joint areas bilaterally. Phy