Rheumatoid arthritis: clinical symptoms and signs, diagnosis and treatment
1. Big picture
Rheumatoid arthritis (RA) is the prototype chronic inflammatory autoimmune arthritis. The examiner wants you to recognize this pattern:
Middle-aged woman + symmetric small-joint inflammatory polyarthritis + morning stiffness + metacarpophalangeal/proximal interphalangeal/wrist involvement + anti-CCP positivity ± erosions.
RA is not just “joint pain.” It is a systemic immune disease that can cause irreversible erosions, deformity, disability, cardiovascular risk, lung disease, nodules, vasculitis, anemia, and cervical spine instability.
The treatment principle is:
Diagnose early → start disease-modifying antirheumatic drug (DMARD) early → treat to remission or low disease activity → prevent erosions and deformity.
Modern guidelines emphasize a treat-to-target strategy with frequent disease activity assessment and treatment adjustment toward remission or low disease activity. ([PMC][1])
Unlock the rest of this topic
Subscribe to Internal Medicine for $10/month and unlock all 229 topics — full exam-structured notes, the State Exam questions integrated into every topic, and the downloadable Anki deck. Cancel anytime.
- ✓All 229 Internal Medicine topics, exam-structured
- ✓State Exam questions in every topic
- ✓Downloadable Anki deck (.apkg)
- ✓Cancel anytime
Already subscribed? Sign in