From the Guidelines
To screen for arthritis, a thorough medical history and physical examination are essential. The healthcare provider should assess for symptoms such as joint pain, stiffness, and swelling, as well as inquire about any family history of arthritis, as recommended by 1.
Key Components of Arthritis Screening
- Medical History: Assess symptoms, family history, and medical history to identify potential risk factors for arthritis 1
- Physical Examination: Examine all peripheral joints for tenderness, swelling, and range of motion, as well as the spine 1
- Laboratory Tests: Complete blood count, erythrocyte sedimentation rate, and C-reactive protein can help identify inflammatory markers 1
- Imaging Studies: X-rays, ultrasound, or MRI may be ordered to evaluate joint damage and inflammation 1
Additional Tests for Suspected Rheumatoid Arthritis
- Anti-cyclic citrullinated peptide and rheumatoid factor antibody tests can be performed to confirm the diagnosis 1
- Autoimmune blood panel, including ANA, RF, and anti-CCP, and inflammatory markers (ESR and CRP) may be considered if symptoms persist 1
Management of Arthritis
- Medications: Acetaminophen or nonsteroidal anti-inflammatory drugs like ibuprofen 400-800mg every 4-6 hours or naproxen 250-500mg every 8-12 hours may be prescribed to manage symptoms 1
- Disease-modifying antirheumatic drugs: Methotrexate 5-20mg weekly or sulfasalazine 500-1000mg twice daily may be considered for patients with rheumatoid arthritis 1
It is essential to consult a healthcare provider for a proper diagnosis and treatment plan, as the management of arthritis depends on the specific type and severity of the condition 1.
From the Research
Screening for Arthritis
To screen for arthritis, particularly rheumatoid arthritis (RA), several methods and tools can be employed, including history-taking, physical examination, laboratory tests, and imaging. The following points highlight the key aspects of screening for arthritis:
- History-taking and physical examination: These are crucial initial steps in diagnosing RA [ 2 ]. Advanced age, female sex, and morning stiffness are predictive of a diagnosis of RA from undifferentiated peripheral inflammatory arthritis (UPIA) [ 2 ].
- Diagnostic criteria and prediction models: The 1987 American College of Rheumatology classification criteria for RA do not perform well as a diagnostic tool in early arthritis, highlighting the need for new diagnostic criteria or prediction models [ 3 ].
- Screening for early arthritis: Early treatment of RA leads to better outcomes, making it essential to identify patients at the earliest possible stage [ 4 ].
- Physical examination and laboratory tests: Recommendations for the physical and laboratory-test follow-up of patients with RA have been developed based on published evidence and expert opinion [ 5 ].
- Standardized physical examination method: A standardized physical examination method for joints to determine RA activity has been proposed using the modified RAND/UCLA Appropriateness Method [ 6 ].
Key Features for Screening
The key features to consider when screening for arthritis include:
- Morning stiffness
- Number of tender and swollen joints
- Small/large joint involvement in the upper/lower extremities
- Symmetrical involvement
- Extraarticular features
- Disability at baseline
These features can help predict progression from UPIA to RA or a poor prognosis [ 2 ].