RHEUMATOID ARTHRITIS-CLINICAL

SUMMARY

1. Causes symmetric polyarteritis with specific involvement of the hands.

2. Signs and symptoms of RA include > 1 hour of morning stiffness/pain that improves with activity, fatigue, low-grade fever, anorexia, and weight loss.

3. Non-inflammatory joint diseases, such as OA, cause < 30 minutes of stiffness, and pain is worse with activity.

4. Symptoms of RA may be intermittent (15-30%) or progressive. Intermittent disease has remissions lasting up to 1 year and is considered a variant of RA known as palindromic rheumatism.

5. General inspection: patients appear Cushingoid due to chornic steroid use.

6. Associated: carpal tunnel/tarsal tunnel syndrome, atlanto-axial instability, T-L-S spine and sacral joints are always spared.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].