Rheumatoid arthritis (RA) is a common autoimmune condition affecting approximately 0.5% to 1% of the global population. A significant percentage of these patients will develop hand deformities and dysfunction. Additionally, the hand is one of the earliest manifestations of the disease. Hand surgeons will often encounter patients with rheumatoid arthritis before the patients have received a diagnosis. Therefore, the hand surgeon must be vigilant recognizing RA’s clinical signs and to have a thorough understanding in the initial assessment of these patients.