Clinical distinction between rheumatoid arthritis and osteoarthritis

Feature	Rheumatoid arthritis	Osteoarthritis
Primary joints affected	Metacarpophalangeal Proximal interphalangeal	Distal interphalangeal Carpometacarpal
Heberden's nodes	Absent	Frequently present
Joint characteristics	Soft, warm, and tender	Hard and bony
Stiffness	Worse after resting (eg, morning stiffness)	If present, worse after effort, may be described as evening stiffness
Laboratory findings	Positive RF Positive anti-CCP antibody Elevated ESR and CRP	RF-negative Anti-CCP antibody-negative Normal ESR and CRP

RF: rheumatoid factor; CCP: cyclic citrullinated peptide; ESR: erythrocyte sedimentation rate; CRP: C-reactive protein.

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