A chronic, erosive arthritis that requires early and aggressive treatment.
Diagnosed clinically. Laboratory and radiographic testing provide prognostic information more often than diagnostic information.
Disease-modifying antirheumatic drugs are the mainstay of management. Methotrexate is commonly used first line; various other agents, including biological agents and small molecule drugs, can be prescribed concomitantly.
Disease activity scores (e.g., 28-joint count version of disease activity score [DAS28], clinical disease activity index [CDAI], simplified disease activity index [SDAI], routine assessment patient index data [RAPID3]) are used routinely to provide optimum care for RA patients.
Rheumatoid arthritis (RA) is a chronic inflammatory condition affecting around 1% of the population, making it the most common inflammatory arthritis seen by physicians. It primarily affects the small joints of the hands and feet and, if not treated aggressively, can be a major cause of work loss, decreased quality of life, need for joint replacement surgery, and mortality. RA is a clinical diagnosis; laboratory and radiographic tests help to confirm the diagnosis and provide useful prognostic information.
History and exam
Clinical Associate Professor of Medicine
New York University School of Medicine
YY receives research support from BMS, Celgene, and Sanofi; he has consulted for Celgene and Sanofi.
Department of Rheumatology
Royal Derby Hospital
CD has received honoraria for talks at symposia sponsored by Wyeth and Abbott.
Nuffield Orthopaedic Centre
Senior Lecturer in Rheumatology
Botnar Research Centre
University of Oxford
RL declares that he has no competing interests.
Professor of Medicine
Section of Rheumatology
University of Wisconsin
AB has received fees for speaking and consulting from Abbott, BMS, UCB, and Genentech.
Emeritus Professor of Rheumatic Diseases
School of Clinical Sciences
University of Bristol
JK declares that he has no competing interests.
Professor of Rheumatology
Arthritis Research UK
Leeds Institute of Rheumatic and Musculoskeletal Medicine
University of Leeds
Leeds Musculoskeletal Biomedical Research Unit
Leeds Teaching Hospitals NHS Trust
Associate Professor of Medicine
Division of Rheumatology
Washington University School of Medicine
PR declares that she has no competing interests.
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