A 43 yeаr-оld Africаn Americаn female presents tо the оffice for warm, stiff joints in her hands and her wrists. She notes that it takes at least 1.5-2 hours for her to get relief in the morning. She also notes low grade fevers that have been occurring for the past several months. On exam, you note warmth and tenderness over her MCP joints bilaterally. Further testing shows that she is positive for Anti-CCP. What is the underlying cause of her symptoms?