Rheumatoid arthritis is a chronic condition characterized by joint inflammation. If treated late or inadequately, structural damage can occur. In Europe, RA is the most common autoimmune disease. In addition, there is an increased risk of osteoporosis and cardiovascular disease, with impact on morbidity and mortality. The treatment of RA has changed significantly with the introduction of biologic therapies. Until now, the choice of biological drug is made based on experience of the rheumatologist, comorbidities, in consultation with the patient. This trial and error approach can lead to treatment failure or delay in achieving the intended remission, in addition to significant social costs. At our centre, ultrasound-guided synovial biopsies of joints with arthritis are performed to study synovial cells and their signatures. Also physiotherapy is a cornerstone of treatment. We study the importance of physiotherapy in controlling joint symptoms and reducing adverse skeletal and general health effects.