Chronic, progressive autoimmune disease causing connective-tissue inflammation, mostly in synovial joints. It can occur at any age, is more common in women, and has an unpredictable course. It usually starts gradually, with pain and stiffness in one or more joints, then swelling and heat. Muscle pain may persist, worsen, or subside. Membrane inflammation and thickening scars joint structures and destroys cartilage. In severe cases, adhesions immobilize and deform the joints, and adjacent skin, bones, and muscles atrophy. If high-dose aspirin, ibuprofen, and other NSAIDs do not relieve pain and disability, low-dose corticosteroids may be tried. Physical medicine and rehabilitation with heat and then range-of-motion exercises reduce pain and swelling. Orthopedic appliances correct or prevent gross deformity and malfunction. Surgery can replace destroyed hip, knee, or finger joints with prostheses. There is also a juvenile form of the disease.

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