A more specific problem caused by inflammation of the synovial lining of joints that leads to destruction of the articular cartilage and causing the joint to fail, leading to progressive pain and disability. Rheumatoid arthritis is the classical type, although there are many other causes. It usually affects small joints in the hands and feet first, although larger joints like the hip and knee can become involved. These conditions are usually managed by a Rheumatologist, with many effective drug treatments now available. The Rheumatologist will send patients for consideration of Orthopaedic Surgery when joints become damaged causing pain and disability.