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Rheumatoid arthritis typically occurs in women from 24-45 years of age. It is a common inflammatory arthritis of unknown cause that can affect any of the synovial joints but consistently affects the hand and wrist.

The classic radiographic findings are soft-tissue swelling, osteopenia, narrowing of the joint spaces due to destruction of articular cartilage, marginal erosions, and malalignments. Ultimately, there is destruction and subluxation resulting in joint deformity.

Malalignments commonly found in the hand and wrist are the swan neck deformity characterized by extension at the proximal interphalangeal joint (PIPJ) and flexion at the distal interphalangeal joint (DIPJ); boutonniere deformity characterized by flexion at the PIPJ and extension at the DIPJ; and ulnar deviation of the fingers at the metacarpophalangeal joints.

Classically there is lack of bone formation and ankylosis. The wrist and midfoot bones may be rarely fused in advanced cases. Abnormalities characteristic for osteoarthritis may be superimposed on the radiographic findings of rheumatoid arthritis.