Difference between revisions of "Rheumatoid arthritis"
m (Rossdonaldson1 moved page RA to Rheumatoid Arthritis) |
(link) |
||
| Line 11: | Line 11: | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
| − | *Septic athritis | + | *[[Septic Arthritis (General)|Septic athritis]] |
*Osteoarthritis | *Osteoarthritis | ||
*Viral arthritis | *Viral arthritis | ||
Revision as of 03:48, 26 March 2014
Contents
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
Workup
- 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
See Also
Sources
Up to Date