| When patients present to the rheumatologist they | | | | imaging and ultrasound are helpful. Diagnostic x-rays |
| often have not yet received a definitive diagnosis. | | | | are of limited use because significant damage can |
| Because there are so many different types of | | | | occur long before it shows up on x-ray. |
| arthritis that present in a similar fashion, the diagnosis | | | | The goals of management include: aggressive and |
| is not always easy to make. | | | | early treatment, reduction of signs and symptoms, |
| Despite all the high tech tools available today, the | | | | prevention of deformities, maintenance of joint |
| most important part of evaluating the patient remains | | | | function, control of co-morbidities (other associated |
| a careful history and physical examination (see Part | | | | disease such as hypertension, diabetes, etc., a patient |
| 3). Helpful diagnostic laboratory tests include the | | | | might have), and possibly... cure. While this last option |
| rheumatoid factor, erythrocyte sedimentation test | | | | is still not quite achievable just yet , it is becoming |
| (ESR), C-reactive protein (CRP), and more recently a | | | | more of a possibility. |
| new test called the anti cyclic citrullinated antibody | | | | In addition to medications, treatment of RA includes |
| (anti-CCP). One note of caution: the presence of a | | | | diet, exercise, joint protection, and occasionally joint |
| positive rheumatoid factor doesn't necessarily indicate | | | | surgery. |
| the diagnosis of rheumatoid arthrits. Multiple other | | | | The approach to RA treatment has changed |
| conditions can cause rheumatoid factor positivity. By | | | | dramatically in the last 5 years. Future articles will |
| the same token, roughly 20 % of patients with | | | | discuss the current management of rheumatoid |
| rheumatoid arthritis are rheumatoid factror negative. | | | | arthritis. |
| Imaging procedures such as magnetic resonance | | | | |