A recent review of thermography studies in rheumatoid arthritis shows limited data about disease activity and mostly focuses on differences between the thermography of rheumatoid arthritis patients and typical subjects. A retrospective study compared patients with high disease activity (n = 50), moderate disease activity (n = 16), and healthy participants (n = 42), taking into account demographic, clinical, laboratory, and thermography parameters. We applied an infrared thermography sensor and a fingers examination protocol. Outcomes included the mean temperature of five fingers of a hand: In static, post-cooling, post-rewarming, the total change in mean temperature of fingers due to cold provocation, the total change in mean temperature of fingers due to rewarming, the area under the cooling curve, the area under the heating curve, the difference between the area under the rewarming and the cooling curve, and temperature intensity distribution maps. For patients with high disease activity, a lower area under the heating curve and a lower difference between the area under the rewarming curve and the cooling curve were observed, as well as a smaller total change in mean temperature due to rewarming, compared to patients with moderate disease activity (p < 0.05). Our study findings could be helpful in patients with an equivocal clinical examination.