Last reviewed: 3 Sep 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
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.
Differentials
- Psoriatic arthritis (PsA)
- Infectious arthritis
- Gout
More DifferentialsGuidelines
- 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
More GuidelinesPatient information
Rheumatoid arthritis
Rheumatoid arthritis: questions to ask your doctor
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