Med. praxi. 2023;20(4):201-210 | DOI: 10.36290/med.2023.034

Rheumatoid arthritis - diagnosis and treatment

prof. MUDr. Petr Němec, Ph.D.

Revmatologická ambulance II. interní kliniky FN u sv. Anny v Brně a LF MU, Brno

Rheumatoid arthritis is a severe chronic autoimmune inflammatory disease affecting 0.5-1% of the population, with a predominance of middle-aged women. Typical symptoms of the disease include pain and stiffness, especially in the small joints of the hands or feet, predominating in the morning, and fatigue. Chronic inflammation of the joints results in structural damage with significant impairment of physical and occupational abilities and impaired quality of life. Extra-articular manifestations of the disease and comorbidities may increase mortality. The diagnosis of rheumatoid arthritis can be established based on a well-taken medical history, and clinical examination with the contribution of laboratory and imaging methods. Current classification criteria may be helpful. The basic principles of rheumatoid arthritis treatment include its early initiation immediately after diagnosis and the choice of an appropriate treatment strategy aimed at achieving and long-term maintaining therapeutic goals. Decisions on treatment strategy should be based on an assessment of disease activity, safety of treatment, and other factors such as the presence of comorbidities and progression of structural damage, and should take into account the patient's preferences as well as the costs associated with treatment. Treatment must be comprehensive, however, pharmacotherapy using disease-modifying antirheumatic drugs is pivotal. Given the chronic and heterogeneous course of the disease, patients may require access to multiple treatment strategies and medications over the course of their lives. General practitioners can make a significant contribution to the early diagnosis of rheumatoid arthritis if they refer patients with clinically suspected disease, with arthritis of at least one of the metacarpophalangeal or metatarsophalangeal joints, to a specialist rheumatology unit promptly, optimally after individual discussion with a rheumatologist.

Keywords: arthritis, diagnostics, rheumatoid, therapy.

Accepted: May 11, 2023; Published: September 26, 2023  Show citation