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Arthritis, Rheumatoid, Emergency Medicine

Reviewed 06/2017



  • Chronic systemic inflammatory disorder that attacks the joints:

    • Nonsuppurative, proliferative synovitis

    • Destruction of the articular cartilage

    • Ankylosis of the joint

  • Involvement of knee ...


Signs and Symptoms

  • Malaise, fatigue

  • Generalized musculoskeletal pain

  • After weeks to months, patients develop swollen, warm, painful joints.

  • Often worse in morning

  • Joint involvement usually symmet...



Cervical spine immobilization and airway support as indicated 

Initial Stabilization/Therapy

  • ABCs:

    • Manage airway with attention to C-spine immobilization during intubation.

  • Treat com...



Admission Criteria

  • Patients with severe or life-threatening presentations of RA and its complications should be admitted to hospital.

  • Admission is warranted when diagnosis is unclea...

Pearls and Pitfalls

  • Recognize that symmetric arthritis is more consistent with RA.

  • Even patients with RA can get septic arthritis.

  • Consult rheumatologist rather than initiate steroids or TNF antagonists...

Additional Reading

  • Imboden  JB. The immunopathogenesis of rheumatoid arthritis. Annu Rev Pathol.  2009;4:417–434.

  • Sanders  S, Harisdangkul  V. Leflunomide for the treatment of rheumatoid arthritis...



714.0 Rheumatoid arthritis 


  • M06.9 Rheumatoid arthritis, unspecified

  • M06.049 Rheumatoid arthritis without rheumatoid factor, unsp hand

  • M06.079 Rheumatoid arthritis w/o rheumatoid factor, un...

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