Summary
Definition
History and exam
Key diagnostic factors
- artritis simétrica activa >6 semanas de duración
- 50 a 55 años de edad
- sexo femenino
- dolor en las articulaciones
- inflamación de las articulaciones
Other diagnostic factors
- rigidez matinal
- deformidad de cuello de cisne
- deformidad de Boutonniere
- desviación cubital
- nódulos reumatoides
- lesiones vasculíticas
- dolor torácico pleurítico
- escleritis y/o uveítis
Risk factors
- predisposición genética
- tabaquismo
- sobrepeso u obesidad
- infección
Diagnostic investigations
1st investigations to order
- factor reumatoide (FR)
- anticuerpo antipéptido cíclico citrulinado (anti-CCP)
- radiografías
- ecografía
Investigations to consider
- puntuaciones de actividad de la enfermedad
Treatment algorithm
actividad leve de la enfermedad en la presentación inicial: no embarazada/ sin planes de embarazo
actividad moderada a grave de la enfermedad en la presentación inicial: no embarazada/sin planes de embarazo
sí está embarazada o está planeando un embarazo
imposibilidad de alcanzar una actividad baja de la enfermedad después de 3 meses de tratamiento: no embarazada/sin planes de embarazo
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.
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.
References
Key articles
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.Full text Abstract
National Institute for Health and Care Excellence. Rheumatoid arthritis in adults: management. Oct 2020 [internet publication].Full text
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.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

Differentials
- Artritis psoriásica (AP)
- Artritis infecciosa
- Gota
More DifferentialsGuidelines
- Australian living guideline for the pharmacological management of inflammatory arthritis
- Guideline for vaccinations in patients with rheumatic and musculoskeletal diseases
More GuidelinesPatient information
artritis reumatoide
Artritis reumatoide: preguntas para formularle al médico
More Patient informationLog in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer