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Arthritis, Rheumatoid (RA)

Mariya Milko, DO, MS Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Chronic systemic autoimmune inflammatory disease with symmetric polyarthritis and synovitis

  • Progressive chronic inflammation leads to large and small joint destruction, deformity, dec...

DIAGNOSIS

HISTORY

  • Symmetric polyarthritis—most commonly of hands and feet

  • Constitutional symptoms: fatigue, malaise, weight loss, low-grade fevers (1)

  • Articular symptoms: tender/swollen joints, early mor...

TREATMENT

GENERAL MEASURES

  • Goal is to achieve remission/minimize disease activity, prevent structural damage, and prevent disability (3)[A].

  • Early, aggressive treatment prevents structural damage and di...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Encourage full activity as tolerated. Avoid heavy work or exercise during active (flare) phases. Emphasize exercise, mobility, and reduction of joint stress. 

Patient Monitoring

REFERENCES

1
Aletaha D, Neogi T, Silman AJ, et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ar...

ADDITIONAL READING

Pincus T, Yazici Y, Bergman MJ. RAPID3, an index to assess and monitor patients with rheumatoid arthritis, without formal joint counts: similar results to DAS28 and CDAI in clinical...

CODES

ICD10

  • M06.9 Rheumatoid arthritis, unspecified

  • M05.60 Rheu arthritis of unsp site w involv of organs and systems

  • M05.30 Rheumatoid heart disease w rheumatoid arthritis of unsp site

  • M05.70 Rheu arthri...

CLINICAL PEARLS

  • Early diagnosis is important to improve outcomes and functional status.

  • Plain films are the initial imaging modality of choice.

  • Early treatment with DMARDs slows disease progression and ...

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