Rheumatology Book

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Rheumatoid Arthritis Diagnosis

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  1. See Also
    1. Rheumatoid Arthritis
    2. Rheumatoid Arthritis Articular Signs
    3. Rheumatoid Arthritis Extra-articular Signs
    4. Felty's Syndrome
    5. Rheumatoid Arthritis Management
    6. Rheumatoid Arthritis Antiinflammatory Medications
    7. Rheumatoid Arthritis Remittive Agents
  2. Pearls
    1. History and Examination are most important
      1. Symmetric involvement
      2. Morning stiffness and gelling
      3. Hand and wrist (esp. MCP joints) involvement
      4. Shaking hands is painful (withdraws hand on squeeze)
    2. Lab and x-ray add little help in diagnosis
      1. Erythrocyte Sedimentation Rate (ESR) may be normal
      2. C-Reactive Protein may be normal
      3. Rheumatoid Factor may be normal
      4. X-Ray may be normal
  3. Characteristics of onset
    1. Onset over weeks to months
    2. Prodromal symptoms of anorexia, weakness, Fatigue
    3. Usually starts in one joint
  4. ACR Rheumatoid Arthritis Diagnostic Criteria
    1. RA Diagnosis requires four of the following
    2. Symptoms that must be present for at least 6 weeks
      1. Morning stiffness in and around joints for >= 1 hour
        1. Most common presenting symptom
      2. Symmetric joint involvement
        1. Most common presenting sign
      3. Soft tissue swelling of at least three joint areas
        1. PIP joint
        2. MCP joint
        3. Wrist joint
        4. Elbow joint
        5. Knee joint
        6. Ankle joint
        7. MTP joint
      4. Swelling of mcp, pip or wrist joints
    3. Signs that may be present at any time
      1. Rheumatoid Nodules (Subcutaneous Nodules) present
      2. Rheumatoid Factor positive
      3. X-ray changes
        1. See XRay Changes in Rheumatic Conditions
        2. Bone Erosions
        3. Periarticular Osteopenia (bone decalcification)
          1. Especially involving the hands and wrists
  5. Resources
    1. American College of Rheumatology (1987) RA Criteria
      1. http://www.rheumatology.org/research/classification

Rheumatoid Arthritis (C0003873)

Definition (MSH)A chronic systemic disease, primarily of the joints, marked by inflammatory changes in the synovial membranes and articular structures, widespread fibrinoid degeneration of the collagen fibers in mesenchymal tissues, and by atrophy and rarefaction of bony structures. Etiology is unknown, but autoimmune mechanisms have been implicated.
Definition (CSP)chronic systemic disease, primarily of the joints, marked by inflammatory changes in the synovial membranes and articular structures, widespread fibrinoid degeneration of the collagen fibers in mesenchymal tissues, and by atrophy and rarefaction of bony structures; etiology is unknown, but autoimmune mechanisms have been implicated.
Definition (NCI)A chronic systemic disease, primarily of the joints, marked by inflammatory changes in the synovial membranes and articular structures, widespread fibrinoid degeneration of the collagen fibers in mesenchymal tissues, and by atrophy and rarefaction of bony structures. Etiology is unknown, but autoimmune mechanisms have been implicated.
ConceptsDisease or Syndrome (T047)
ICD9714.0, 714.0
MSHD001172
EnglishARTHRITIS RHEUMATOID, Atrophic arthritis, Chronic rheumatic arthritis, RA, RA - Rheumatoid arthritis, RhA - Rheumatoid arthritis, Rheumatic gout, Rheumatoid Arthritis, Rheumatoid disease
Spanishartritis atrofica, artritis reumatica cronica, artritis reumatoide, gota reumatica
Parent ConceptsInflammatory polyarthritis (C1692871), [X]Inflammatory polyarthropathies (C1692324), Arthritis (C0003864), Autoimmune Diseases (C0004364), Arthropathies NOS (C0022408), COLLAGEN VASCULAR DISEASE (C0262428), Multiple Organ Syndromes NEC (C0549513), Rheumatoid arthritis and other inflammatory polyarthropathies (C0157913), Rheumatism (C0035435), Rheumatologic Disorder (C0748408), Rheumatoid Arthritis (C0003873), Arthropathy associated with a hypersensitivity reaction (C0263730), Duplicate concept (C1274013), Delayed hypersensitivity disorder (C1960693)
SourcesAIR, AOD, COSTAR, CSP, CST, DXP, ICD9CM, MEDLINEPLUS, MSH, MTH, MTHICD9, NCI, NDFRT, OMIM, QMR, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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