A 45-year-old male presents with symmetric small joint swelling and pain accompanied by morning stiffness for 3 years. Over the past 3 months, symptoms worsened with prolonged morning stiffness, dry cough, shortness of breath, and dyspnea on exertion (no paroxysmal nocturnal dyspnea). Examination reveals swollen/tender wrist and MCP joints, reduced grip strength, painless subcutaneous nodules on elbows, and bilateral Velcro rales in lower lung fields. The most likely diagnosis is: