Difference between revisions of "Rheumatoid arthritis"

(Sources)
Line 23: Line 23:
 
*Fibromyalgia
 
*Fibromyalgia
  
==Workup==
+
==Diagnosis==
 
*Xray affected joints
 
*Xray affected joints
 
*Rheumatoid factor
 
*Rheumatoid factor
Line 32: Line 32:
  
 
==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
Line 47: Line 47:
 
*[[Arthritis]]
 
*[[Arthritis]]
  
==Sources==
+
==References==
Up to Date
 
  
 
[[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

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

See Also

References