Ver el código de «Rheumatoid arthritis»

==Background==
*Rheumatoid arthritis is an autoimmune disease. It is an erosive polyarthritis that causes auto-antibodies direct against an individual's own joints and joint spaces.

==Clinical Features==
[[File:Rheumatoid_nodules.jpg|thumb|Rheumatoid nodules on the extensor surfaces can develop in poorly controlled rheumatoid arthritis]]
[[File: swan neck deformity.jpg|thumb|Multiple [[swan neck deformity|swan neck deformities]] from poorly controlled rheumatoid arthritis]]
*Morning stiffness
*[[Polyarthritis]] of MCP and PIP joints
**Does NOT involve DIP joints
**Wrists, elbows, shoulders, ankles, knees also commonly involved
*Ulnar deviation at MTP joints
*[[Swan neck deformity]]
*Rheumatoid nodules
*Most patients initially diagnosed in the early 50s
*Common associated conditions in severe cases: pleuritis, [[interstitial lung disease]], [[pericarditis]], inflammatory eye disease

==Differential Diagnosis==
*[[Septic Arthritis (General)|Septic arthritis of previously injured joint]]
{{Differential Diagnosis Polyarthritis}}
{{Differntial Diagnosis Oligoarthritis}}
{{Differencial Diagnosis Migratory Arthritis}}

==Evaluation==
*Xray affected joints for erosions
*Rheumatoid factor (positive in 60% to 70% of patients)
*Anti-cyclic citrullinated peptide (CCP) antibodies (positive in about 70% of patients)
*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
*[[Opioids]] have a limited role
*Disease-modifying antirheumatic drug (DMARD)
**Can be started by primary care provider or rheumatologist after ER visit

==Disposition==
*Discharge with referral to PCP or rheumatology

==See Also==
*[[Arthritis]]

==References==
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[[Category:Rheumatology]]