Rheumatoid arthritis
Summary
Definition
Анамнез и осмотр
Ключевые диагностические факторы
- active symmetric arthritis lasting >6 weeks
- age 50 to 55 years
- female sex
- joint pain
- joint swelling
Другие диагностические факторы
- morning stiffness
- swan neck deformity
- Boutonniere deformity
- ulnar deviation
- rheumatoid nodules
- vasculitic lesions
- pleuritic chest pain
- scleritis and/or uveitis
Факторы риска
- genetic predisposition
- smoking
- overweight or obesity
- infection
Диагностические исследования
Исследования, которые показаны в первую очередь
- rheumatoid factor (RF)
- anticyclic citrullinated peptide (anti-CCP) antibody
- radiographs
- ultrasonography
Исследования, проведение которых нужно рассмотреть
- disease activity score(s)
- MRI
Алгоритм лечения
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
failure to reach low disease activity after 3 months of therapy: not pregnant or planning pregnancy
Составители
Авторы
Yusuf Yazici, MD
Clinical Associate Professor of Medicine
New York University School of Medicine
New York
NY
Раскрытие информации
YY receives research support from BMS and Amgen; he has consulted for Amgen, BMS, Hemay, Chugai, and Sanofi.
Рецензенты
Joshua F. Baker, MD, MSCE
Associate Professor of Medicine and Epidemiology
University of Pennsylvania
Pennsylvania
PA
Раскрытие информации
JFB has received consulting fees from Bristol-Myers Squibb, Pfizer, Cumberland Pharma, and CorEvitas.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Список литературы
Основные статьи
Fraenkel L, Bathon JM, England BR, et al. 2021 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol. 2021 Jul;73(7):1108-23.Полный текст Аннотация
National Institute for Health and Care Excellence. Rheumatoid arthritis in adults: management. Oct 2020 [internet publication].Полный текст
Smolen JS, Landewé RBM, Bergstra SA, eta al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2022 update. Ann Rheum Dis. 2023 Jan;82(1):3-18 Epub 2022 Nov 10.Полный текст Аннотация
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Psoriatic arthritis (PsA)
- Infectious arthritis
- Gout
Больше ОтличияGuías de práctica clínica
- 2023 American College of Rheumatology (ACR) guideline for the screening and monitoring of interstitial lung disease in people with systemic autoimmune rheumatic disease
- Guideline for vaccinations in patients with rheumatic and musculoskeletal diseases
Больше Guías de práctica clínicaFolletos para el paciente
Rheumatoid arthritis
Rheumatoid arthritis: questions to ask your doctor
Más Folletos para el paciente
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