Joint pain

September 2010

FocusJoint pain

Rheumatoid arthritis

Volume 39, No.9, September 2010 Pages 626-628


Rheumatoid arthritis is a chronic disease that can cause irreversible joint damage and significant disability. With a prevalence of 1%, it has a considerable cost to the community. Diagnosis is based on a combination of clinical and laboratory features. Patients typically present with a symmetrical polyarthritis of the small joints of the hands and feet accompanied by early morning stiffness and, occasionally, constitutional symptoms.


This review discusses the role of the general practitioner in the diagnosis and early management of rheumatoid arthritis.


It is increasingly recognised that there is a ‘window of opportunity’ within which disease modifying antirheumatic drug therapy should be commenced to arrest progressive disease and joint destruction. Methotrexate is usually the first line agent in the management of rheumatoid arthritis but simple analgesia and nonsteroidal anti-inflammatory drugs are also important for symptom control.

Rheumatoid arthritis (RA) is a chronic disease with significant cost to both the individual and the community. In 2007, RA accounted for over $400 million of Australian health expenditure.1 With increasing recognition that uncontrolled disease leads to irreversible joint damage and progressive disability, it is imperative that RA is diagnosed in a timely fashion to allow early intervention with appropriate disease modifying antirheumatic drugs (DMARDs). With these issues in mind, The Royal Australian College of General Practitioners (RACGP) developed Guidelines for the diagnosis and management of early rheumatoid arthritis,2 released in August 2009. This article draws on the recommendations of that guideline.

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