Imaging may be very helpful in making your decision to see if you have any joints with active rheumatoid arthritis.

FYI, methotrexate is used for inflammatory conditions beyond rheumatoid arthritis. It is called a DMARD (disease-modifying antirheumatic drug) because it helps slow/prevent bone damage and perhaps other tissue damage. Once damaged it is unlikely to heal properly.

Whether you choose to go on methotrexate can depend on whether your treatment goal is pain management or disease management. Steroids might have been helpful for pain for some folks but not for me as I have type 2 diabetes. I chose to start methotrexate because of my pain levels, and because certain inflammatory markers were elevated. (Note if goal is pain management, the relief will not be immediate, rather it may take several weeks). I was able to decrease my NSAID use as the other agents got to effective levels.

I have seronegative RA, osteoarthritis in various places around my body, and erosive arthritis in my hands. I may fibromyalgia too. I take hydroxychloroquine, methotrexate, and Enbrel for the RA pain. I use oxaprozin and diclofenac gel for the rest.