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Arthritis, Rheumatoid (RA)

Sonia Gupta, MD Reviewed 05/2023
 


BASICS

DESCRIPTION

  • Rheumatoid arthritis (RA) is a chronic inflammatory disease primarily causing synovial inflammation and leading to the destruction of bone and cartilage  (1).

  • Classification: based on...

DIAGNOSIS

HISTORY

Arthritis is insidious in onset, symmetrically involving small joints, morning stiffness ≥1 hour, improvement with activity, low-grade fever, and weight loss. 

PHYSICAL EXAM

  • Symmetric s...

TREATMENT

Treat to target approach is strongly recommended over usual care for patients who have not been previously treated with DMARDS (both traditional and biologics) 

GENERAL MEASURES

Smoking cessat...

ONGOING CARE

DIET

Avoid fatty foods and eat lots of fruits and vegetables. 

PROGNOSIS

Poor prognosis with an autoantibody and longer disease duration, HLA, erosive disease 

COMPLICATIONS

Anemia, lymphoprol...

REFERENCES

1
Taylor PC. Update on the diagnosis and management of early rheumatoid arthritis. Clin Med (Lond). 2020;20(6):561–564. doi: 10.7861/clinmed.2020-0727.
2
Singh JA, Saag KG, Bridges SL, et al. ...

ADDITIONAL READING

SEE ALSO

  • Cush JJ. Rheumatoid arthritis: early diagnosis and treatment. Med Clin North Am. 2021;105(2):355–365. 

  • Sánchez-Flórez JC, Seija-Butna...

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 treatment with DMARDs is essential. Treat to target approach.

  • Methotrexate is the first-line treatment for active disease and glucocorticoids are used for flares if patients are a...

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