Last reviewed: November 2017
Last updated: September  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • splenomegaly
  • joint deformities

Other diagnostic factors

  • rheumatoid nodules
  • hepatomegaly
  • hx of vasculitis
  • frequent skin and respiratory tract infections

Risk factors

  • rheumatoid arthritis (RA) >10 years
  • FHx of RA
  • age >50 years
  • white ethnicity

Diagnostic investigations

1st investigations to order

  • FBC
  • peripheral blood smear
  • serum ESR
  • serum CRP
  • LFTs
  • serum RF
Full details

Investigations to consider

  • serum ANA
  • serum anti-cyclic citrullinated peptide (anti-CCP) antibodies
  • ultrasound of abdomen
  • CT scan of abdomen
  • CXR
  • bone marrow biopsy
  • virological tests
Full details

Treatment algorithm

ACUTE

Contributors

Authors VIEW ALL

Dobrina N. Hull

Consultant Rheumatologist

Kingston Hospital

Kingston upon Thames

UK

Disclosures

DH declares that she has no competing interests.

Gerald Coakley

Consultant Rheumatologist

Queen Elizabeth Hospital

London

UK

Disclosures

GC is the author of one reference cited in this monograph.

Peer reviewers VIEW ALL

Consultant Rheumatologist and Honorary Senior Clinical Lecturer in Rheumatology

Selly Oak Hospital

Birmingham

UK

Disclosures

SB declares that he has no competing interests.

Medical Director

Mary Pack Arthritis Program

Clinical Associate Professor

University of British Columbia

Vancouver

BC

Canada

Disclosures

AK is the author of a study referenced in this monograph.

Professor and Vice Chair

Department of Medicine

University of Wisconsin Hospital

Madison

WI

Disclosures

AB declares that he has no competing interests.

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