Rheumatoid arthritis: Difference between revisions
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*Fibromyalgia | *Fibromyalgia | ||
== | ==Diagnosis== | ||
*Xray affected joints | *Xray affected joints | ||
*Rheumatoid factor | *Rheumatoid factor | ||
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==Management== | ==Management== | ||
*NSAIDs | *[[NSAIDs]] | ||
**Symptomatic relief without slowing underlying disease | **Symptomatic relief without slowing underlying disease | ||
*Glucocorticoids | *[[Glucocorticoids]] | ||
**Consider intraarticular injection if a single joint is inflammed | **Consider intraarticular injection if a single joint is inflammed | ||
**Systemic steroids reserved for moderate-severe flairs | **Systemic steroids reserved for moderate-severe flairs | ||
*Opiods have a limited role | *[[Opiods]] have a limited role | ||
*Disease-modifying antirheumatic drug (DMARD) | *Disease-modifying antirheumatic drug (DMARD) | ||
**Can be started by PMD or Rheumatologist after ER visit | **Can be started by PMD or Rheumatologist after ER visit | ||
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*[[Arthritis]] | *[[Arthritis]] | ||
== | ==References== | ||
[[Category:Rheum]] | [[Category:Rheum]] | ||
Revision as of 17:11, 27 July 2015
Background
- Erosive polyarthritis
Clinical Features
- Morning stiffness
- Polyarthritis of MCP and PIP joints
- Does NOT involve DIP joints
- Wrists, elbows, shoulders, ankles, knees also commonly involved
- Ulnar deviation at the wrist
- Rheumatoid nodules
Differential Diagnosis
- Septic athritis
- Osteoarthritis
- Viral arthritis
- SLE
- Psoriatic arthritis
- Lyme Disease
- Gonococcal arthritis
- Gout
- Pseudogout
- Juvenile idiopathic arthritis
- Fibromyalgia
Diagnosis
- Xray affected joints
- Rheumatoid factor
- Anti-cyclic citrullinated peptide (CCP) antibodies
- ANA
- Consider arthrocentesis
- WBC count typically 1,500-20,000
Management
- NSAIDs
- Symptomatic relief without slowing underlying disease
- Glucocorticoids
- Consider intraarticular injection if a single joint is inflammed
- Systemic steroids reserved for moderate-severe flairs
- Opiods have a limited role
- Disease-modifying antirheumatic drug (DMARD)
- Can be started by PMD or Rheumatologist after ER visit
Disposition
- Refer to PMD or rheumatologist