[Rheumatoid arthritis: a general disease and local diseases]

The rheumatoid synovitis affects the joints by destroying the cartilage, the sub-chondral bone and the articular capsule. The tendons and ligaments can be degraded by proximity or by the means of the affected synovial sheaths. This conjunction of effects involves a foreseeable degradation on the complex articulations whose clinician must know the stages to interfere effectively into a preventive way by local interventions when the general treatments of the disease are insufficient and before recourse to the repairing surgery. This management can only be considered with a team where the general practitioner has a central place of alarm. Extraarticular symptoms (Sjogren's syndrome, cardiac, pulmonary or renal involvement) are specific local diseases and should be managed appropriately by the general practitioner and referred specialists.