This article is a personal paper, and it is strictly forbidden to reprint it! Thank you. It can be said that almost all patients with rheumatoid arthritis have involved the hand and wrist joints successively, and most of them are the first and characteristic deformed parts. Among the most common clinical diagnostic criteria, the importance of hand joint diseases in clinical treatment is emphasized and it is listed as an essential diagnostic item. When I get up in the morning, my fingers are stiff and swollen, and I can't hold my fist. In medicine, this phenomenon is called morning stiffness, which is a characteristic manifestation of rheumatoid arthritis. The early manifestations of rheumatoid arthritis are diamond-shaped swelling in the proximal interphalangeal joint (the knuckle near the wrist) and swelling and pain in the metacarpophalangeal joint (the joint between the finger and the palm). Swelling of the wrist back is also one of the early signs of rheumatoid arthritis, which involves the extensor tendon sheath of the hand. Inflammation around styloid process of ulna can cause soft tissue swelling and local tenderness, which is of great significance to the diagnosis of rheumatoid arthritis. When the disease develops to the advanced stage, the inflammation of extensor tendon sheath leads to tendon rupture and contracture. If the proximal interphalangeal joint is overstretched and the distal interphalangeal joint flexes, the symptoms of "gooseneck" deformity will be formed. In addition, it will also lead to the formation of "button flower", "telescope hand" and "cone finger". It is very common that the articular surface is damaged, the hand muscles are atrophied, and the strength between muscle groups is unbalanced, which leads to the phenomenon of "ulnar deviation" when wrist synovitis proliferates. The proliferated synovium can extend to the palm side, and a palpable mass can be formed under the palm muscle groups. Because the thickened transverse carpal ligament compresses the median nerve in the tube, carpal tunnel syndrome appears, which is characterized by abnormal numbness and tingling of the hand at night, and finally thenar muscle weakness and atrophy. 50% patients with rheumatoid arthritis have thumb involvement and deformity. I can't stretch my thumb at the beginning. With the further development of inflammation, the metacarpophalangeal joints are flexed and fixed, and the interphalangeal joints are overstretched, resulting in "Z" deformity and lateral displacement. X-ray examination of hands and wrists is very important for early diagnosis and curative effect monitoring of rheumatoid arthritis. Early X-ray manifestations include swelling of soft tissue, decalcification of bone around joints and narrowing of joint space. In the later stage, joint space disappears, bone erosive destruction and various deformities may occur. The X-ray manifestation of the hand is also an important diagnostic index. Hand joint is the most common and earliest part of rheumatoid arthritis, which will form a variety of characteristic deformities in the later stage, seriously affecting people's quality of life. Therefore, no matter from the angle of diagnosis or treatment, we should pay attention to the diseases of hand joints in order to achieve the purpose of syndrome differentiation and treatment.