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Arthritis, Rheumatoid (RA)

Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Rheumatoid arthritis (RA) is a chronic autoimmune systemic inflammatory disease (1).

  • RA primarily involves synovial inflammation and proliferation leading to destruction of juxta-arti...

DIAGNOSIS

HISTORY

  • Early complaints include difficulty using hands and foot pain with weight-bearing.

  • Arthritis is typically insidious in onset, gradually progressing and symmetrically involving small jo...

TREATMENT

GENERAL MEASURES

  • Reduce disease activity with the aim to induce remission/decrease disease activity, decrease joint destruction, prevent disability.

  • If remission cannot be attained, aim of tre...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Laboratory monitoring for DMARDs (2
  • Follow CBC, liver transaminases, serum creatinine

  • More frequent follow-up is required within first 3 months at initiation of m...

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...

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.

  • Methotrexate is the first-line treatment for active disease and glucocorticoids are used for flares if patients are already on DMARD therapy.

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