Rheumatoid arthritis beyond the textbook: Asymmetric hand deformities with rare bilateral hallux manifestations

Rheumatoid arthritis is a chronic systemic auto-immune disease characterised by persistent synovial inflammation, progressive joint destruction and deformity. It classically presents as a symmetrical polyarthritis involving the small joints of the hands and feet, and this symmetry remains one of its hallmark clinical features. Foot involvement is equally common and contributes significantly to disability, although it is often under-recognised in routine clinical practice. However, asymmetric deformity progression and atypical foot manifestations are rarely highlighted in the literature.