MONTAGE: JOINT: Course of Rheumatoid Arthritis, Clinical and radiographic progression -- NORMAL METACARPOPHALANGEAL JOINTS; left image-clinical; right image-radiograph -- CLINICAL-A lack of synovitis or effusion of the knuckle is noted by the presence of a groove between the knuckles. RADIOGRAPHIC-There is no soft tissue swelling, a maintained radiographic join (PLAIN FILM)