@tisme My joints and the soft tissue in my fingers/hands/wrists (and sometimes feet) swell and get red/warm/even hot to touch. Leflunomide is keeping it mostly controlled, but I am at my maximum dose. My Rheumatologist says when it ceases to work, we will look at biologics because I am not a candidate for methotrexate, sulfasalazine or hydroxychloroquine. I also use topical Voltaren gel at bedtime on bad days.