What finding is characteristic of rheumatoid arthritis in a physical exam?

Rheumatoid arthritis (RA) is known for its symmetric involvement of joints, which is a defining characteristic of the condition. During a physical exam, one would typically observe swelling and inflammation in the same joints on both sides of the body, indicating the autoimmune nature of RA. This symmetric joint swelling often involves the small joints of the hands and feet, making it distinct from other forms of arthritis that may present unilaterally or with less symmetrical patterns.

The other options do not accurately represent the classic findings associated with RA. Unilateral pain would suggest a different etiology, and while gouty tophi are associated with gout, they are not a feature of RA. Similarly, limited range of motion due to bony restriction is more indicative of osteoarthritis or other types of joint pathology, rather than the soft tissue involvement characteristic of rheumatoid arthritis. Thus, the presence of symmetric joint swelling is a hallmark finding when assessing a patient for rheumatoid arthritis during a physical examination.