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Diagnosis and clinical features of rheumatoid arthritis 

Diagnosis and clinical features of rheumatoid arthritis
Chapter:
Diagnosis and clinical features of rheumatoid arthritis
DOI:
10.1093/med/9780199556755.003.0003
Page of

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date: 13 June 2021

Patients with rheumatoid arthritis should be diagnosed as early as possible so that effective treatment can be initiated to prevent joint damage and comorbidities

Any swelling or persistent (>3 weeks) pain and stiffness in multiple joint areas should prompt referral to a rheumatologist

Typical joint patterns in RA include involvement of the metacarpophalangeal, metatarsophalangeal, wrist, and knee joints

The more difficult differential diagnosis is fibromyalgia, which also can co-exist in 20% of cases

Rheumatoid factor and ACPA testing are useful in making the diagnosis in patients with appropriate clinical features, and predicts poor radiological outcome, but >30% of patients are negative for these tests

More than 40% of patients have normal ESR and CRP.

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