类风湿性关节炎

最后审阅: 6 九月 2022
最后更新: 14 十二月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 持续>6 周的活动性对称性关节炎
  • 年龄在 50-55 岁之间
  • 女性
  • 关节痛
  • 关节肿胀
更多 关键诊断因素

其他诊断因素

  • 晨僵
  • 天鹅颈样畸形
  • 钮扣状畸形
  • 尺侧偏斜
  • 类风湿结节
  • 血管炎性损伤
  • 胸膜炎性胸痛
  • 巩膜炎和/或葡萄膜炎
其他诊断因素

危险因素

  • 遗传易感性
  • 吸烟
更多 危险因素

诊断性检查

首要检查

  • 类风湿因子 (RF)
  • 抗环瓜氨酸肽(抗 CCP)抗体
  • 影像学检查
  • 超声检查
更多 首要检查

需考虑的检查

  • 疾病活动度评分
更多 需考虑的检查

治疗流程

急症处理

最初发病时疾病活动度呈轻度:非妊娠或计划妊娠

最初发病时有中度至重度疾病活动度:非妊娠或计划妊娠

妊娠或计划妊娠

持续性治疗

经 3 个月治疗后病情未达到低疾病活动度者:未妊娠或无计划妊娠

撰稿人

作者

Yusuf Yazici, MD
Yusuf Yazici

Clinical Associate Professor of Medicine

New York University School of Medicine

New York

NY

利益声明

YY receives research support from BMS and Genentech; he has consulted for Amgen, BMS, and Sanofi.

同行评议者

Chris Deighton, BMedSc, MD, FRCP

Consultant Rheumatologist

Department of Rheumatology

Royal Derby Hospital

Derby

UK

利益声明

CD has received honoraria for talks at symposia sponsored by Wyeth and Abbott.

Raashid Luqmani, DM FRCP, FRCP(E)

Consultant Rheumatologist

Nuffield Orthopaedic Centre

Senior Lecturer in Rheumatology

Botnar Research Centre

University of Oxford

Oxford

UK

利益声明

RL declares that he has no competing interests.

Alan Bridges, MD

Professor of Medicine

Section of Rheumatology

University of Wisconsin

Madison

WI

利益声明

AB has received fees for speaking and consulting from Abbott, BMS, UCB, and Genentech.

John Kirwan, BSc, MB, BS, MD

Emeritus Professor of Rheumatic Diseases

School of Clinical Sciences

University of Bristol

Bristol

UK

利益声明

JK declares that he has no competing interests.

Paul Emery, MA, MD, FMedSci

Professor of Rheumatology

Arthritis Research UK

Director

Leeds Institute of Rheumatic and Musculoskeletal Medicine

University of Leeds

Director

Leeds Musculoskeletal Biomedical Research Unit

Leeds Teaching Hospitals NHS Trust

Leeds

UK

利益声明

Not disclosed.

Prabha Ranganathan, MD, MS

Associate Professor of Medicine

Division of Rheumatology

Washington University School of Medicine

St Louis

MO

利益声明

PR declares that she has no competing interests.

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