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artritis reumatoide

Last reviewed: 13 Oct 2025
Last updated: 08 Aug 2024

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
Full details

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
Full details

Risk factors

  • predisposición genética
  • tabaquismo
  • sobrepeso u obesidad
  • infección
Full details

Diagnostic investigations

1st investigations to order

  • factor reumatoide (FR)
  • anticuerpo antipéptido cíclico citrulinado (anti-CCP)
  • radiografías
  • ecografía
Full details

Investigations to consider

  • puntuaciones de actividad de la enfermedad
Full details

Treatment algorithm

ACUTE

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

ONGOING

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
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.

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

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

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.
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