Rheumatoid arthritis (RA) is a chronic, progressive, systemic inflammatory disease characterized by progressive destruction of the synovial joints, with loss of cartilage and bone. Damage to ligaments and tendons occurs in most patients. The long-term impact of RA on patients extends beyond the destruction of the joints, however. If left untreated, it can cause debilitating changes that affect both morbidity and mortality. The life expectancy of RA patients is reduced by 5 to 15 years. Improvement in patient care requires a cooperative team effort between primary care clinicians (PCCs), rheumatologists, physical and occupational therapists, and the patient's family. PCCs are the key players in successful management through early recognition of the signs and symptoms of RA, referral to a rheumatologist for initiation of disease-modifying antirheumatic drug (DMARD) therapy, and continued long-term monitoring and management of RA progression and potential adverse effects of DMARD therapy.
This newsletter discusses the early diagnosis of RA in primary care, and the clinical management of RA patients in the early stages of the disease.
Upon completion of this activity, the learner should be able to:
- Correctly identify patients who have probable early RA and should be referred to a rheumatologist
- Employ the ôsqueeze testö to assist with diagnosis of RA
- Evaluate patients by using functional assessment questions when RA is suspected
Martin M. Miner, MD
Co-Director, Men's Health Center
The Miriam Hospital
Providence, RI
Stephen A. Paget, MD, FACP, FACR
Physician-in-Chief
Department of Medicine
Hospital for Special Surgery
New York, NY
The Chatham Institute is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Chatham Institute designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
It is the policy of The Chatham Institute to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. All faculty, planners, and managers who affect the content of medical education activities sponsored by The Chatham Institute are required to disclose to the audience any real or apparent conflict of interest related to the activity. Faculty, planners, and managers not complying with the disclosure policy will not be permitted to participate in this activity.
Program faculty and planners have disclosed the financial relationships with commercial interests cited below. All program content has been peer reviewed for balance and any potential bias. The conflict of interest resolution process aims to ensure that financial relationships with commercial interests and resultant loyalties do not supersede the public interest in the design and delivery of continuing medical education activities for the profession.
Martin M. Miner, MD
No real or apparent conflicts to report
Stephen A. Paget, MD, FACP, FACR
Dr. Paget is a consultant for Abbott Laboratories and Genentech, Inc.
Daniel Duch, PhD
Medical Director, The Chatham Institute
No real or apparent relationships to disclose
Cynthia Fontan, MPA
Education Manager, The Chatham Institute
No real or apparent relationships to disclose
This educational activity is sponsored by The Chatham Institute. Support for this independent educational activity is provided by educational grants from Abbott Laboratories, Centocor, Inc., and Genentech and Biogen Idec.
