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All main topics / Medicine / Pharmacology / PharmaSkills
50
What do I do upon suspicion of a new case of rheumatoid arthritis?
● Formally you suspect early rheumatoid arthritis in patients with more than 2, usually symmetrically distributed, usually small joints which have been painful and swollen for >6 weeks irrespective of physical activity and remain stiff in the morning for >60 min.
● As the above symptoms vary in scope and persistence, confirm the tenttative diagnosis using the 2010 ACR/EULAR Rheumatoid Arthritis Classification scoring system or refer the patient to a rheumatologist.
Do not hesitate with confirming diagnostics or referring your patient, as you may miss the most significant therapeutic window of opportunity! The first months are characterized not only by the fastest disease progression but also by the best treatment response! The therapy should commence within 3 months since symptom onset, yet this is achieved in <25% of patients!
Ibuprofen (not glucocorticoids - interference with further diagnostics!) can be prescribed immediately for symptoms relief.  
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Flashcard info:
Author: LWojnowski
Main topic: Medicine
Topic: Pharmacology
School / Univ.: University Clinical Center
City: Mainz
Published: 24.05.2013

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