In addition, patients with early RA often do not present with the classic, symmetrical polyarthritis involving the hands, wrists, feet, and ankles. Initially, RA often begins with just 1 or 2 inflamed joints. Other joints typically become inflamed over time. Early on, RA joint swelling may come and go, and there are few systemic symptoms. Atypical joints, such as the jaw, will be painful, mimicking temporomandibular joint disorder (TMJD). Subcutaneous nodules are rarely seen in early RA. Laboratory testing is of limited diagnostic use in early RA, but the acute phase reactants—either an ery

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