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Artrite reumatoide

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 18 Aug 2025
Last updated: 08 Aug 2024

Summary

Definition

History and exam

Key diagnostic factors

  • artrite simétrica ativa com duração >6 semanas
  • idade entre 50 e 55 anos
  • sexo feminino
  • dor nas articulações
  • edema na articulação
Full details

Other diagnostic factors

  • rigidez matinal
  • deformidade de pescoço de cisne
  • deformidade em botoeira
  • desvio ulnar
  • nódulos reumatoides
  • lesões vasculíticas
  • dor torácica pleurítica
  • esclerite e/ou uveíte
Full details

Risk factors

  • predisposição genética
  • tabagismo
  • sobrepeso ou obesidade
  • infecção
Full details

Diagnostic investigations

1st investigations to order

  • fator reumatoide (FR)
  • anticorpo antipeptídeo citrulinado cíclico (anti-CCP)
  • radiografias
  • ultrassonografia
Full details

Investigations to consider

  • índice(s) de atividade da doença
Full details

Treatment algorithm

ACUTE

atividade leve da doença na manifestação inicial: não gestante ou planejando gestação

atividade moderada a grave da doença na manifestação inicial: não gestante ou planejando gestação

gestante ou planejando gestação

ONGOING

falha em alcançar uma atividade de doença baixa após 3 meses de terapia: não gestante ou planejando gestação

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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