Rheumatoid Arthritis

Question 1

Which joints are commonly affected in rheumatoid arthritis?

Answer 1

• MCP
• PIP
• MTP
• Wrists
• Ankles
• Elbows

Question 2

What signs and symptoms might someone with rheumatoid arthritis present with?

Answer 2

• Symmetric arthritis > 6 weeks
• Joint pain (MCP, PIP, MTP, wrists, ankles, elbows)
• Joint swelling
• Morning stiffness
• Systemic signs
• Swan-neck/Boutonierre deformity

Question 3

How might you investigate someone suspected to have rheumatoid arthritis?

Answer 3

• FBE/CRP/ESR
• Anaemia of chronic disease
• RF/anti-CCP
• Radiographs

Question 4

How might you manage someone with rheumatoid arthritis?

Answer 4

• Pain management
  
  • Paracetamol, NSAIDs
• Flare management
  
  • Prednisolone
• Disease modification
  
  • Methotrexate with folic acid + other agents if response not adequate
  • Biologicals
• Physiotherapy, psychosocial support, smoking cessation