Almost half of the patients experience arthritis in the hips or the shoulders. Up to 30% of the patients suffer from small joint involvement with swelling, pain and stiffness in the inflamed joints. Often these appear as asymmetrical oligoarthritis. Usually they are non- erosive, but deformity and consequently destruction of the hips have been seen. An early involvement of peripheral joints can be an indicator of a more aggressive progress. Peripheral joint involvement can occur at any stage of the disease (Sieper J, Braun J, Rudwaleit M, Boonen A, Zink A) (Gladman DD). .
