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Assess Morning Stiffness Carefully
- Differentiate inflammatory arthritis from mechanical by timing of symptoms, mainly morning stiffness lasting over 30 minutes.
- Ask how joints feel upon waking and observe if stiffness limits movement.
Classify Arthritis Types Clinically
- Rheumatoid arthritis mainly involves symmetrical small joints, sparing DIP joints, unlike osteoarthritis or psoriatic arthritis.
- Inflammatory arthritis includes autoimmune, spondylarthropathy, infectious, and crystalline types with distinct characteristics.
Key Labs for RA Diagnosis
- Order ESR, standard CRP (not highly sensitive), rheumatoid factor, and CCP antibody when evaluating suspected rheumatoid arthritis.
- Avoid ANA testing initially to prevent false positives and unnecessary further testing.