Final answer:
Rheumatoid arthritis involves inflammation of the synovial membrane, damage to articular cartilage, ossification of fibrous tissues with bone fusion, and can cause significant hand deformities; thus, the correct answer is E. all of the above.
Step-by-step explanation:
In rheumatoid arthritis (RA), multiple processes occur as the disease progresses. Initially, the synovial membrane becomes inflamed and thickens, forming a mass (Option C). As RA evolves, the articular cartilage is damaged, and fibrous tissue can invade (Option B), leading to joint deformity. Over time, fibrous tissues may ossify, and bones may fuse together, contributing to changes in joint structure (Option A). It is also commonly observed that the hands can look very deformed due to these processes (Option D). Therefore, the correct answer to the student's question is E. all of the above.