Rheumatoid arthritis

Data gathering

  • Red flags – fever, weight loss
  • Others – swelling, eye symptoms, breathing problems, skin rashes, morning stiffness, mood
  • Examine – joints (MCP), grip, sensation, nails

 

Clinical management

  • Investigations
    • Bloods – FBC, ESR, CRP, anti-CCP
    • XR
  • Explanation
    • Arthritis means irritation of joints. In RA, the immune system attacks tissues of the joints – main symptoms are pain and stiffness of the joints
  • Treatment
    • Refer to Rheum – should be seen within 3 months for medications (DMARDs + steroids)
    • Analgesia
    • Physiotherapy, occupational therapy
    • Vaccinations
  • Follow-up / Safety net
    • yearly RA review
    • methotrexate monitoring