Rheumatoid Arthritis Questions & Answers

Updated: Aug 22, 2019
  • Author: Howard R Smith, MD; Chief Editor: Herbert S Diamond, MD  more...
  • Print
Questions & Answers

Overview

What is rheumatoid arthritis (RA)?

What are the signs and symptoms of rheumatoid arthritis (RA)?

Which assessments should be included in the physical exam for rheumatoid arthritis (RA)?

Which lab studies are helpful in the diagnosis of rheumatoid arthritis (RA)?

Which imaging modalities are helpful in the diagnosis of rheumatoid arthritis (RA)?

Is joint aspiration useful in the diagnosis of rheumatoid arthritis (RA)?

Other than medication and surgery, which therapies exist for rheumatoid arthritis (RA)?

Which nonbiologic DMARDS are used to treat rheumatoid arthritis (RA)?

Which biologic tumor necrosis factor (TNF)-inhibiting DMARDS are used to treat rheumatoid arthritis (RA)?

Which biologic non–tumor necrosis factor (TNF) DMARDS are used to treat rheumatoid arthritis (RA)?

What drugs other than DMARDS are used to treat rheumatoid arthritis (RA)?

Which surgical procedures are used to treat rheumatoid arthritis (RA)?

What are the main features of rheumatoid arthritis (RA)?

What lab test results suggest rheumatoid arthritis (RA)?

How is rheumatoid arthritis (RA) treated?

What is macrophage activation syndrome as it relates to juvenile idiopathic arthritis (JIA)?

What are the treatment guidelines for managing rheumatoid arthritis (RA) to therapeutic target?

What is the pathogenesis of rheumatoid arthritis (RA)?

Which cells have a major role in the pathophysiology of rheumatoid arthritis (RA)?

What causes the tissue destruction in rheumatoid arthritis (RA)?

Is rheumatoid arthritis (RA) genetic?

What causes rheumatoid arthritis (RA)?

What is juvenile idiopathic arthritis (JIA), and is it genetically similar to rheumatoid arthritis (RA)?

What is the role of genomic imprinting and epigenetics in the etiology of rheumatoid arthritis (RA)?

Which infectious agents may cause rheumatoid arthritis (RA)?

Do sex hormones increase the risk of developing rheumatoid arthritis (RA)?

What is the role of immunologic factors in the development of rheumatoid arthritis (RA)?

What is the role of T cells in the pathogenesis of rheumatoid arthritis (RA)?

What is the role of B cells in the pathology of rheumatoid arthritis (RA)?

What is the role of synovial membrane in the pathology of rheumatoid arthritis (RA)?

What is the global prevalence of rheumatoid arthritis (RA) among different age groups and ethnicities?

Does rheumatoid arthritis (RA) in first-degree relatives increase risk?

Is rheumatoid arthritis (RA) more common in women or men?

What are the possible clinical outcomes of rheumatoid arthritis (RA)?

How can early treatment improve the prognosis in rheumatoid arthritis (RA)?

What factors correlate with an unfavorable prognosis in rheumatoid arthritis (RA)?

Which findings are associated with radiographic progression in patients who received methotrexate (MTX) for rheumatoid arthritis (RA)?

Which lab results suggest a poor prognosis in rheumatoid arthritis (RA)?

How does duration of rheumatoid arthritis (RA) affect prognosis?

What is the prevalence of full employment among patients with rheumatoid arthritis (RA)?

What risk factors contribute to mortality in rheumatoid arthritis (RA)?

What nontraditional cardiovascular risk factors contribute to mortality and morbidity in rheumatoid arthritis (RA)?

What is the mortality rate in rheumatoid arthritis (RA)?

What are the benefits of patient education and counseling in rheumatoid arthritis (RA)?

What is the best way to inform patients about their diagnosis of rheumatoid arthritis (RA)?

What is the best way to communicate prognosis and treatment options to patients and their families after a diagnosis of rheumatoid arthritis (RA)?

Is it beneficial to tell a patient that there are no controllable causes for rheumatoid arthritis (RA)?

What is the best response to a patient expressing interest in alternative and complementary forms of therapy for rheumatoid arthritis (RA)?

What are the common misconceptions about the effectiveness of less costly rheumatoid arthritis (RA) treatments?

What are the benefits of active participation of families in the management of patients with rheumatoid arthritis (RA)?

What is a common fear in patients with rheumatoid arthritis (RA)?

What is the best approach to supporting patients with severe rheumatoid arthritis (RA)?

Presentation

What are the main features of rheumatoid arthritis (RA)?

What is juvenile idiopathic arthritis (JIA)?

What is the impact of rheumatoid arthritis (RA) on a patient’s ability to perform activities of daily living (ADLs)?

Is the onset of rheumatoid arthritis (RA) insidious or abrupt?

What should be assessed in a physical exam for rheumatoid arthritis (RA)?

How does rheumatoid arthritis (RA) affect the elbow?

How does rheumatoid arthritis (RA) affect the cervical spine?

Which joints are affected by rheumatoid arthritis (RA) and what are the symptoms?

What are the musculoskeletal manifestations of rheumatoid arthritis (RA) other than joint involvement?

What is a boutonniere deformity in rheumatoid arthritis (RA)?

What is a swan-neck deformity of the finger in rheumatoid arthritis (RA)?

How is tightness of intrinsic muscles due to rheumatoid arthritis (RA) assessed?

What is the prognosis of flexor tenosynovitis/trigger finger due to rheumatoid arthritis (RA)?

What is arthritis mutilans (opera glass hands) due to rheumatoid arthritis (RA)?

How does rheumatoid arthritis (RA) affect metacarpophalangeal (MCP) joints?

How does rheumatoid arthritis (RA) affect the wrist?

How does rheumatoid arthritis (RA) affect the shoulders?

How does rheumatoid arthritis (RA) affect the ankles and feet?

How does rheumatoid arthritis (RA) affect the knees?

How does rheumatoid arthritis (RA) affect the hips?

What are clinical manifestations of early cervical spine disease due to rheumatoid arthritis (RA)?

What are the manifestations of neurologic involvement in the cervical spine due to rheumatoid arthritis (RA)?

What do transient ischemic attacks (TIAs) and cerebellar signs indicate in rheumatoid arthritis (RA)?

What are symptoms of cervical myelopathy in rheumatoid arthritis (RA)?

How can stiffness caused by rheumatoid arthritis (RA) be determined during physical exam?

How is stiffness in rheumatoid arthritis (RA) relieved?

How are pain and tenderness assessed during physical exam in rheumatoid arthritis (RA)?

How is enlargement of the synovial membrane noted on physical exam in rheumatoid arthritis (RA)?

How is synovial proliferation identified during a physical exam in rheumatoid arthritis (RA)?

How does a Baker cyst form in rheumatoid arthritis (RA)?

Where are Baker cysts most commonly found in rheumatoid arthritis (RA)?

How does rheumatoid arthritis (RA) cause joint deformity?

How does rheumatoid arthritis (RA) cause limitation of motion?

What are the common extra-articular manifestations of rheumatoid arthritis (RA)?

How do rheumatoid nodules affect patients with rheumatoid arthritis (RA)?

Which organ systems are affected by rheumatoid arthritis (RA)?

How does rheumatoid arthritis (RA) affect the heart/cardiovascular system?

How does rheumatoid arthritis (RA) affect the lungs?

How does rheumatoid arthritis (RA) affect the kidneys?

How does rheumatoid arthritis (RA) affect the GI system?

Where do vasculitis lesions develop in rheumatoid arthritis (RA)?

Is anemia a presentation of rheumatoid arthritis (RA)?

Is nerve entrapment a presentation of rheumatoid arthritis (RA)?

How does rheumatoid arthritis (RA) affect the eye?

What are the ACR and EULAR diagnostic criteria for rheumatoid arthritis (RA)?

Who should be tested for rheumatoid arthritis (RA), according to 2010 ACR/EULAR criteria?

What is the 2010 ACR/EULAR classification system for rheumatoid arthritis (RA)?

What are the 2012 ACR recommendations for the measurement of disease activity in rheumatoid arthritis (RA)?

What are the 4 stages of progression of rheumatoid arthritis (RA)?

What are the ACR–recommended rheumatoid arthritis (RA) disease activity cutoffs?

What is the 2011 ACR/EULAR definition of remission in rheumatoid arthritis (RA)?

How is remission in rheumatoid arthritis (RA) predicted?

What are the rheumatoid arthritis (RA) disease activity measure cutoffs that indicate disease remission for patient-driven composite tools?

What are the rheumatoid arthritis (RA) disease remission cutoffs for RA patient, provider, and lab composite tools?

What are the 4 functional classes of rheumatoid arthritis (RA)?

Is rheumatoid arthritis (RA) fatal?

How can rheumatoid arthritis (RA) affect daily life?

Which parts of the body are affected by rheumatoid arthritis (RA) in addition to joints?

DDX

How is rheumatoid arthritis (RA) differentiated from other diseases?

How is rheumatic fever differentiated from rheumatoid arthritis (RA)?

How is systemic lupus erythematosus (SLE) differentiated from rheumatoid arthritis (RA)?

How is degenerative joint disease (DJD) differentiated from rheumatoid arthritis (RA)?

How is gouty arthritis differentiated from rheumatoid arthritis (RA)?

How is pyogenic arthritis differentiated from rheumatoid arthritis (RA)?

How is chronic Lyme disease differentiated from rheumatoid arthritis (RA)?

How is polymyalgia rheumatica differentiated from rheumatoid arthritis (RA)?

How are carcinomas differentiated from rheumatoid arthritis (RA)?

What are the differential diagnoses for Rheumatoid Arthritis?

Workup

How is rheumatoid arthritis (RA) diagnosed?

Which lab studies are useful in the diagnosis of rheumatoid arthritis (RA)?

Which inflammation markers are associated with rheumatoid arthritis (RA)?

What are the hematologic findings consistent with a diagnosis of rheumatoid arthritis (RA)?

What are the immunologic findings consistent with a diagnosis of rheumatoid arthritis (RA)?

Is rheumatoid factor (RF) specific to rheumatoid arthritis (RA)?

What is the significance of antinuclear antibodies (ANAs) in rheumatoid arthritis (RA)?

Are assays for anti-citrullinated protein antibodies (ACPA) used to diagnose rheumatoid arthritis (RA)?

Can anti-cyclic citrullinated peptide (anti-CCP) antibodies testing be used to diagnose rheumatoid arthritis (RA)?

Can rheumatoid arthritis (RA) biomarkers be used to diagnose early RA?

How does pregnancy affect lab results in rheumatoid arthritis (RA)?

How is radiography used to assess rheumatoid arthritis (RA)?

How is MRI used to assess rheumatoid arthritis (RA)?

Is ultrasonography useful in the assessment of patients with rheumatoid arthritis (RA)?

What is the most effective method of hand imaging in rheumatoid arthritis (RA)?

What is the most effective method of spinal imaging in rheumatoid arthritis (RA)?

When should joint aspiration and synovial fluid analysis be considered in patients with rheumatoid arthritis (RA)?

Which synovial fluid analysis findings suggest rheumatoid arthritis (RA)?

Which histologic findings suggest rheumatoid arthritis (RA)?

Treatment

What is the most effective management approach for rheumatic arthritis (RA)?

What are the nonpharmacological treatment options for rheumatoid arthritis (RA)?

What can a doctor do to boost morale and ensure compliance with therapy in patients with rheumatoid arthritis (RA)?

What are the pharmacologic treatment options for rheumatoid arthritis (RA)?

What impact does pregnancy have on the treatment of rheumatoid arthritis (RA)?

What are the surgical options in the treatment of rheumatoid arthritis (RA)?

Should patients with rheumatoid arthritis (RA) taking anti-tumor necrosis factor (TNF) agents avoid live-virus vaccines?

Are live-virus vaccines safe in patients with rheumatoid arthritis (RA) who are taking anti-tumor necrosis factor (TNF) agents?

Which medications are used in the treatment of rheumatoid arthritis (RA)?

Are biologic agents or nonbiologic DMARDs more effective in improving physical function in rheumatoid arthritis (RA)?

Which vaccinations are recommended by the ACR prior to pharmacologic treatment for rheumatoid arthritis (RA)?

What are the Agency for Healthcare Research and Quality (AHRQ) recommendations for the pharmacologic therapy of rheumatoid arthritis (RA)?

Which nonbiologic and biologic DMARDs are used for rheumatoid arthritis (RA)?

What is the role of DMARDs in the management of rheumatoid arthritis (RA)?

What are the benefits of early treatment of rheumatoid arthritis (RA) with DMARDs?

Which nonbiologic DMARDs decrease the risk of diabetes in rheumatoid arthritis (RA)?

Which DMARDs are most effective in triggering remission of rheumatoid arthritis (RA)?

What are the indications of methotrexate (MTX) subcutaneous autoinjector (Otrexup) in rheumatoid arthritis (RA)?

What is leflunomide and is it effective to treat rheumatoid arthritis (RA)?

Which tumor necrosis factor (TNF) inhibitors are used in the treatment of rheumatoid arthritis (RA)?

When should biologic agents be considered for treatment of rheumatoid arthritis (RA)?

What are the adverse effects of biologic agents used to treat rheumatoid arthritis (RA)?

What are the contraindications to the use of tumor necrosis factor (TNF) inhibitors in the treatment of rheumatoid arthritis (RA)?

What are the risks of anti-tumor necrosis factor (TNF) therapy in rheumatoid arthritis (RA)?

How do tumor necrosis factor (TNF) inhibitors compare to methotrexate (MTX) in the treatment of rheumatoid arthritis (RA)?

At what blood level is adalimumab (Humira) most effective on disease activity in rheumatoid arthritis (RA)?

What are the effects of certolizumab in rheumatoid arthritis (RA)?

What is golimumab and is it effective in treating rheumatoid arthritis (RA)?

What is the role of rituximab in the treatment of rheumatoid arthritis (RA)?

What is the role of anakinra in the treatment of rheumatoid arthritis (RA)?

What is the role of abatacept in the treatment of rheumatoid arthritis (RA)?

How is abatacept administered in patients with rheumatoid arthritis (RA)?

How is tocilizumab administered in patients with rheumatoid arthritis (RA)?

How is sarilumab administered in patients with rheumatoid arthritis (RA)?

What is the role of janus kinases (JAKs) in the treatment of rheumatoid arthritis (RA)?

When is tofacitinib indicated in the treatment of rheumatoid arthritis (RA)?

How effective is tofacitinib in the treatment of rheumatoid arthritis (RA)?

How effective are DMARDs in the treatment of rheumatoid arthritis (RA)?

How is disease activity reduced in refractory rheumatoid arthritis (RA)?

When should drug combination therapy be considered for the treatment of rheumatoid arthritis (RA)?

How are the adverse effects of combination therapy for rheumatoid arthritis (RA) managed?

What are the most common adverse effects of combination therapy for rheumatoid arthritis (RA)?

What are the possible adverse effects of antimalarial agents used for rheumatoid arthritis (RA)?

What are possible adverse effects of DMARDs in rheumatoid arthritis (RA)?

Does anti-tumor necrosis factor (TNF) therapy for rheumatoid arthritis (RA) increase mortality rates in comparison to standard nonbiologic DMARD therapy?

Do tumor necrosis factor (TNF) inhibitors increase the risk of malignancy in rheumatoid arthritis (RA)?

What role do corticosteroids play in the treatment of rheumatoid arthritis (RA)?

What are possible adverse effects of corticosteroid use in the treatment of rheumatoid arthritis (RA)?

What is the role of NSAIDS in the treatment of rheumatoid arthritis (RA)?

What are possible adverse effects of NSAIDS in the treatment of rheumatoid arthritis (RA)?

What is the role of analgesics in the treatment of rheumatoid arthritis (RA)?

What experimental therapies are under investigation for the management of rheumatoid arthritis (RA)?

Are biologic agents recommended in rheumatoid arthritis (RA) with chronic heart failure?

What are the EULAR guidelines to prevent overtreatment of rheumatoid arthritis (RA)?

What are the ACR recommendations for the use of DMARDS in the treatment of rheumatoid arthritis (RA)?

Is the use of biologic agents recommended in rheumatoid arthritis (RA) and hepatitis?

Is the use of biologic agents safe in patients with rheumatoid arthritis (RA) who have had cancer?

What are the treatment recommendations for rheumatoid arthritis (RA) in patients who have had cancer?

Which patients should be screened for latent TB infection (LTBI) before initiating biologic agents for the treatment of rheumatoid arthritis (RA)?

Which latent TB infection (LTBI) screening tests should be performed before initiating treatment of rheumatoid arthritis (RA) with biologic agents?

Which vaccinations should be administered prior to treatment of rheumatoid arthritis (RA) with DMARDs or biologic agents?

Are there guidelines for the use of anti-tumor necrosis factor (TNF) drugs to treat rheumatoid arthritis (RA) during pregnancy?

Which treatments should be considered for acute presentations of rheumatoid arthritis (RA)?

How is Felty syndrome treated in rheumatoid arthritis (RA)?

How are Baker cysts treated in rheumatoid arthritis (RA)?

How is carpal tunnel syndrome (CTS) treated in rheumatoid arthritis (RA)?

How does pregnancy affect the course of rheumatoid arthritis (RA)?

Which rheumatoid arthritis (RA) medications are considered low-risk in pregnant women?

What should be considered before initiating therapy in pregnant patients with rheumatoid arthritis (RA)?

Is contraception required for women treated with DMARD therapy for rheumatoid arthritis (RA)?

Should women with rheumatoid arthritis (RA) be monitored during the postpartum period?

What are the goals of rheumatoid arthritis (RA) rehabilitation?

What treatments are available to a physiatrist working with patients with rheumatoid arthritis (RA)?

Do heat and cold therapies relieve the symptoms of rheumatoid arthritis (RA)?

Are orthotic devices and splints beneficial in the treatment of rheumatoid arthritis (RA)?

What is the role of therapeutic exercise in the management of rheumatoid arthritis (RA)?

What are the benefits of aerobic conditioning in rheumatoid arthritis (RA)?

What interventions have been shown to increase activity levels in rheumatoid arthritis (RA)?

Which exercises are beneficial in rheumatoid arthritis (RA) and muscle atrophy?

Do strengthening hand exercises improve hand function in rheumatoid arthritis (RA)?

What are the goals of occupational therapy in rheumatoid arthritis (RA)?

What is the role of an occupational therapist in the management of rheumatoid arthritis (RA)?

What is the role of splints used to treat upper-extremity orthoses in rheumatoid arthritis (RA)?

Are there assistive devices for patients with rheumatoid arthritis (RA)?

What are the components of a joint-protection program in rheumatoid arthritis (RA)?

Is an energy conservation program beneficial in rheumatoid arthritis (RA)?

What is the purpose of surgical intervention in rheumatoid arthritis (RA)?

What are the surgical options for rheumatoid arthritis (RA) of the hand and wrist?

What causes cervical spine instability in rheumatoid arthritis (RA)?

Guidelines

Who should be tested for rheumatoid arthritis (RA), according to ACR/EULAR criteria?

What is the ACR/EULAR classification system for rheumatoid arthritis (RA)?

What are the ACR recommendations for the measurement of rheumatoid arthritis (RA) disease activity?

What are the ACR guidelines on the measurement of disease remission for rheumatoid arthritis (RA)?

What are the guidelines for treating rheumatoid arthritis (RA) to therapeutic target?

What are the EULAR treatment guidelines for early rheumatoid arthritis (RA)?

What are the ACR treatment guidelines for early rheumatoid arthritis (RA)?

What are the EULAR guidelines for pharmacologic therapy in rheumatoid arthritis (RA)?

What are the ACR treatment guidelines for established rheumatoid arthritis (RA)?

Medications

Which medications are used in the treatment of rheumatoid arthritis (RA)?

Which medications in the drug class DMARDs, Other are used in the treatment of Rheumatoid Arthritis?

Which medications in the drug class DMARDs, Immunomodulators are used in the treatment of Rheumatoid Arthritis?

Which medications in the drug class DMARDs, TNF Inhibitors are used in the treatment of Rheumatoid Arthritis?

Which medications in the drug class DMARDs, JAK Inhibitors are used in the treatment of Rheumatoid Arthritis?

Which medications in the drug class Tetracyclines are used in the treatment of Rheumatoid Arthritis?

Which medications in the drug class Nonsteroidal Anti-inflammatory Drugs are used in the treatment of Rheumatoid Arthritis?

Which medications in the drug class Analgesics, Other are used in the treatment of Rheumatoid Arthritis?

Which medications in the drug class Opioid Analgesics are used in the treatment of Rheumatoid Arthritis?

Which medications in the drug class Topical Skin Products are used in the treatment of Rheumatoid Arthritis?

Which medications in the drug class Corticosteroids are used in the treatment of Rheumatoid Arthritis?

Which medications in the drug class Chelators are used in the treatment of Rheumatoid Arthritis?