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