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Synovial inflammation and the destruction which results from recurrent and chronic inflammation lead to arthritis and tenosynovitis. Clinical manifestations are bilateral and symmetrical, affecting virtually all joints. The hands and the feet are the main targets. Cervical involvement should be routinely investigated. X-rays demonstrate the erosion and deformation caused by rheumatoid arthritis. Altogether, the manifestations of the disease constitute a distinct and painful handicap. Treatment should be undertaken as early as possible in the course of rheumatoid arthritis in an attempt to avoid evolution toward irreversible destruction.

Diagnosis of microcrystalline arthritis often is based on joint punctures, performed whenever possible. The clinical features of the crises may suggest diagnosis, but is not decisive. The course before or during treatment is not indicative and cannot fully exclude infection when the patient is seen during a crisis; arthritis with one or several microcrystals is possible, as in forms associated with joint infection. For well-oriented management, good knowledge of such diagnostic difficulties is necessary.