A 68-year-old woman presented to the rheumatology department for her semiannual appointment. With a history of long-standing rheumatoid arthritis, diagnosed 30 years earlier, the patient presented severe joint deformities, on both hands and feet. Examination of the hands showed metacarpophalangeal and dorsal subluxation, with ulnar deviation of the fingers and radial deviation of the wrist. These findings also included the Mallet finger, a flexion deformity of the distal interphalangeal joints of the middle and ring fingers, caused by a disruption of the extensor mechanism. Examination of the feet showed a left hallux valgus, a rheumatoid nodule on the left index toe and various examples of hammertoe deformities, which resulted from an imbalance of the digital extensor and flexor tendons that caused a contracture at the proximal interphalangeal joints. Despite the irreversible structural damage and consequent difficulty in performing daily activities, she remained pain-free with daily oral analgesics and low-dose corticosteroids.