Rheumatoid Arthritis

Definition

Joint pain with visible joint swelling.

Inc. Rheumatoid & Reactive Services - Rheumatology

When to Refer

1. All patients with definite joint swelling for more than three months.
2. Patients refractory to or intolerant of NSAIDS.
3. Patient for whom joint disease impairs their ability to cope with daily activities.
4. There is some evidence that commencement of Second-Line Agents may reduce initial impact of the disease.
   

Investigations

• FBC
• ESR
• Biochemical profile (P5)
• Rheumatoid factor (RF)
• Anti-nuclear factor (ANF, particularly if RF < 1/40)
• Xray hands, feet and chest
  

First Line Treatment

1. Adequate simple analgesia.

2. Anti-Inflammatory / NSAID taken regularly.
   

Special Points

1. RF <1/80 is insignificant but co-existent peripheral symmetrical polyarthritis warrants further investigation.
2. Education has been shown to significantly reduce the impact of the disease and improve overall management.

Document Information
Expiry Date: 11/04/04
Author: Kennedy Tom Dr
Organisation: Arrowe Park Hospital