Which statement best characterises rheumatoid arthritis?

Correct answer: C. It arises from a combination of genetic susceptibility and environmental triggers

• A. That describes OSTEOARTHRITIS. RA is inflammatory, with a proliferative synovial pannus that erodes cartilage and bone.
• B. RA is roughly 2–3 times MORE common in WOMEN, with peak onset between 30 and 50 years.
• C. CORRECT. Rheumatoid arthritis is a chronic systemic AUTOIMMUNE disease arising from GENETIC susceptibility — most notably the HLA-DRB1 'shared epitope' — acting together with ENVIRONMENTAL triggers, of which smoking is the best established, alongside periodontal disease (Porphyromonas gingivalis and protein citrullination), silica exposure and the microbiome.
• D. ANA is the hallmark of SYSTEMIC LUPUS ERYTHEMATOSUS. It may be positive in around 30–40% of RA patients but is neither sensitive nor specific for it. The characteristic serology of RA is rheumatoid factor and, more specifically, anti-CCP (anti-citrullinated peptide) antibodies.

Note: Dental relevance: symmetrical small-joint involvement (MCP, PIP) with morning stiffness lasting over an hour; TMJ involvement is common and may cause an anterior open bite from condylar resorption; limited manual dexterity impairs oral hygiene; Sjögren syndrome is a frequent overlap; and methotrexate, biologics and corticosteroids carry implications for infection risk, bleeding and adrenal suppression.