Background 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.
Objective This review discusses the role of the general practitioner
in the diagnosis and early management of rheumatoid
Discussion 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.
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