Rheumatoid Arthritis (RA)

Classically symmetrical small joint arthralgias / arthritis
  • Hands (primarily MCPs & PIPs), Wrists, Feet, Ankles
  • Morning stiffness >30-60 min.
  • Symptoms present >6 weeks
  • ≥3 joints
  • May present atypically w/ Monoarticular disease
 Diagnosis:
  • Rheumatoid Factor: >50 IU/mL 95% sensitive (not specific)
  • Cyclic Citrulinated Peptide antibodies (CCP):  >95% specific
  • Joint Erosions on XR (hands, feet, wrists, ankles)
  • SeroNegative RA may occur in 1/3 of patients
  • NOTE:  High level seropositivity in general population
Natural History
  • Variable remissions, relapses, resolution
  • Can permanently cripple
  • Interstitial lung disease can be fatal
  • Immunocompromising (both the disease & its Tx)

See posting Polyarthralgias.