Which autoimmune arthritis typically presents with symmetric joint swelling and prolonged morning stiffness?

• A. Osteoarthritis
• B. Rheumatoid arthritis
• C. Gout
• D. Ankylosing spondylitis

Answer: (B)

Symmetric swelling of multiple joints with prolonged morning stiffness points to an autoimmune inflammatory arthritis where the immune system targets the synovium. This pattern is classic for rheumatoid arthritis, which tends to involve many joints on both sides (often small joints of the hands and wrists) and stiffness that lasts for an hour or more in the morning, reflecting ongoing synovial inflammation.

In contrast, osteoarthritis is a degenerative, usually asymmetric process that causes brief morning stiffness and tends to affect weight-bearing joints and the DIP joints with bony overgrowths. Gout typically presents as acute, very painful, unilateral joints (often the big toe) rather than a symmetric polyarthritis. Ankylosing spondylitis mainly targets the spine and sacroiliac joints with inflammatory back pain and enthesitis, with peripheral joint involvement being less prominent early on.