The diagnosis of rheumatoid arthritis (RA) starts with a careful history and physical examination. Answers to questions such as:
0How did the symptoms begin?
0When did they begin?
0What joints are involved?
0How long does the stiffness in the morning last?
0How has your level of fatigue changed?
0What do you have difficulty doing that you could do without trouble before your symptoms began?
0 are very helpful.
Valuable diagnostic laboratory tests include the rheumatoid factor, anti-CCP, erythrocyte sedimentation test (ESR), and C-reactive protein (CRP).
Imaging tests such as magnetic resonance imaging and ultrasound are helpful. X-rays are of limited use because significant damage can occur before it shows up on x-ray.
It’s important to realize that progression of RA is closely associated with the development of disability. It is also associated with the development of other potential problems such as early cardiovascular events such as heart attacks and strokes.
Before discussing treatment, let0s look at the goals of treatment. These include: control of signs and symptoms, prevention of deformity, maintenance of joint function, control of co-morbidities (other associated disease such as hypertension, diabetes, etc.), and restoration of normal activities of daily living.
Current treatment options involving medications include:
Non-steroidal anti inflammatory drugs help reduce pain and improve function. They do not have […]

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