Rheumatoid Arthritis Clinical Presentation

Study Notes

The ultimate goal of treating rheumatoid arthritis (RA) is to achieve complete remission or low disease activity, in addition to reducing inflammation, managing symptoms, preserving joint function, and delaying disability.
Non-pharmacologic therapies for RA include patient education, physical therapy, exercise, assistive devices, occupational therapy, and weight loss to reduce joint stress.
Pharmacologic therapies for RA include conventional and biologic disease-modifying antirheumatic drugs (DMARDs) and small-molecule oral Janus kinase (JAK) inhibitors to slow disease progression.
RA is a chronic autoimmune condition primarily affecting joints and the synovium, with systemic manifestations, caused by genetic susceptibility, nongenetic factors, and triggering events such as unknown infectious processes.
Clinical presentation of RA includes symmetric joint involvement, joint stiffness (typically worse in the morning), inflammation, bony erosions, deformities, and extra-articular complications like rheumatoid nodules and interstitial lung disease.
Diagnosis of RA is based on scoring systems like the criteria revised by the American College of Rheumatology and the European League Against Rheumatism in 2010, with a score of 6 or more out of 10 indicating definite RA.
Treatment options for RA include initiating conventional DMARDs like methotrexate, biologic DMARDs such as TNF inhibitors and non-TNF biologics, and JAK inhibitors, with methotrexate being the preferred initial choice unless contraindicated.

Description

Learn about the clinical presentation of rheumatoid arthritis including nonspecific prodromal symptoms, symmetric joint involvement, and joint stiffness worse in the morning. Understand the joint locations commonly affected and other key features of this autoimmune disease.