Clinical Manifestations a The usually age at onset is 35-50 years a The ratio of female to male is 3: 1 The onset of ra is usually insidious a Systemic symptoms of fatigue, fever, weight loss anorexia, generalized weakness may be seenClinical Manifestations  The usually age at onset is 35-50 years  The ratio of female to male is 3:1  The onset of RA is usually insidious  Systemic symptoms of fatigue, fever, weight loss anorexia, generalized weakness may be seen