Although arthrocentesis can be performed by experienced clinicians using clinical landmarks, aspiration and injection of deeper joints (hip), complicated joints (wrist), and even large joints such as the knee and…
The first agents in this category were inhibitors of TNF-α (anti–TNF-α agents). Currently, five of these drugs have been approved by the U.S. Food and Drug Administration: • Adalimumab (fully…
Nonsteroidal Anti-inflammatory Drugs (NSAIDs). NSAIDs interfere with the production of prostaglandins and thus are effective in the reduction of inflammation and, therefore, pain. Many patients will require these agents along…
These studies have proposed a sequence of events in the development of rheumatoid arthritis: (1) An unknown causative factor (antigen), carried to the joint by the circulation, initiates synovitis. (2)…
These goals include: • Education of the patient • Relief of pain • Preservation and restoration of function • Modification of disease progression and damage With the acquired understanding of…
Thrombocytosis, elevated erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) usually correlate with the rheumatoid disease activity rather than disease severity. These laboratory tests are thus of some value in…
Ocular Changes. About 30% patients with rheumatoid arthritis have features of Sjögren syndrome, called secondary Sjögren syndrome. Keratoconjunctivitis is commonly associated with rheumatoid arthritis. Granulomatous scleritis occurs less often but…
IMMUNOLOGIC FEATURES The serum of most patients with rheumatoid arthritis contains immunoglobulins, or antibodies. The autoantibodies to gamma globulin (IgG) are called rheumatoid factors. The latex fixation tests commonly used…
EXTRA-ARTICULAR MANIFESTATIONS Rheumatoid arthritis is a systemic illness, not just a disease of the joints, and thus has a variety of nonarticular, or extra-articular, manifestations (see Plates 5-6 and 5-7)….
FOOT INVOLVEMENT Joint involvement in the foot resembles that in the hand, except for deformities that are determined chiefly by the foot’s weight-bearing function (see Plate 5-4). The toes usually…
