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
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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