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Rheumatoid arthritis

Last reviewed: 2 Oct 2024
Last updated: 08 Aug 2024

Summary

Definition

History and exam

Key diagnostic factors

  • active symmetric arthritis lasting >6 weeks
  • age 50 to 55 years
  • female sex
  • joint pain
  • joint swelling
Full details

Other diagnostic factors

  • morning stiffness
  • swan neck deformity
  • Boutonniere deformity
  • ulnar deviation
  • rheumatoid nodules
  • vasculitic lesions
  • pleuritic chest pain
  • scleritis and/or uveitis
Full details

Risk factors

  • genetic predisposition
  • smoking
  • overweight or obesity
  • infection
Full details

Diagnostic tests

1st tests to order

  • rheumatoid factor (RF)
  • anticyclic citrullinated peptide (anti-CCP) antibody
  • radiographs
  • ultrasonography
Full details

Tests to consider

  • disease activity score(s)
Full details

Treatment algorithm

ACUTE

mild disease activity at initial presentation: not pregnant or planning pregnancy

moderate-to-severe disease activity at initial presentation: not pregnant or planning pregnancy

pregnant or planning pregnancy

ONGOING

failure to reach low disease activity after 3 months of therapy: not pregnant or planning pregnancy

Contributors

Authors

Yusuf Yazici, MD
Yusuf Yazici

Clinical Associate Professor of Medicine

New York University School of Medicine

New York

NY

Disclosures

YY receives research support from BMS and Amgen; he has consulted for Amgen, BMS, Hemay, Chugai, and Sanofi.

Peer reviewers

Joshua F. Baker, MD, MSCE

Associate Professor of Medicine and Epidemiology

University of Pennsylvania

Pennsylvania

PA

Disclosures

JFB has received consulting fees from Bristol-Myers Squibb, Pfizer, Cumberland Pharma, and CorEvitas.

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  • Patient information

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