Rheumatology Edition | When to Suspect (RA) Rheumatoid Arthritis
Jan 25, 2024
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In this podcast, rheumatologist Vanessa L. Kronzer discusses rheumatoid arthritis (RA), including its clinical manifestations, challenges in diagnosis, and effective treatment and management options. Topics covered include risk factors, atypical presentations, use of x-rays for diagnosis, and management with drugs like methotrexate and TNF inhibitors. They also explore achieving remission and burnt out RA.
Rheumatoid arthritis can have atypical presentations and may cause extra-articular manifestations in up to 40% of patients.
Early diagnosis and treatment of rheumatoid arthritis are crucial to achieve remission and minimize complications.
Deep dives
Key Point 1: Rheumatoid arthritis is a common health condition that often takes a long time to diagnose
Rheumatologic problems are some of the most common health conditions primary care professionals encounter. Diagnosis of rheumatoid arthritis can be frustrating and time-consuming, often taking months or even years to establish. New tests are available to aid in diagnosing the condition, along with multiple new and effective treatment options.
Key Point 2: Risk factors and clinical manifestations of rheumatoid arthritis
Rheumatoid arthritis disproportionately affects more women than men, with a ratio of 2 to 3 to 1. It is more common in individuals in their 30s as well as those in their 50s to 60s, but can occur at any age. Genetic factors also play a role, with the HLA region being an area of specific study. Risk factors such as smoking, obesity, and respiratory tract diseases contribute to an increased risk of developing rheumatoid arthritis. Clinically, rheumatoid arthritis often presents with symmetric joint involvement, particularly in the hands and feet, although atypical presentations are not uncommon.
Key Point 3: Management and treatment options for rheumatoid arthritis
Early diagnosis and treatment are crucial in rheumatoid arthritis to improve outcomes. Methotrexate remains the first-line treatment, but if patients do not respond, other options include TNF inhibitors, Jack inhibitors, IL-6 inhibitors, and other biologics. The goal of treatment is to achieve remission, and with the variety of available treatments, remission rates are high. Regular monitoring and follow-up are essential to manage the disease and minimize complications, including non-articular manifestations such as interstitial lung disease and increased risk of heart disease and lymphoma.
Rheumatologic problems are some of the most common health conditions we see as primary care professionals. In many cases, taking months and sometimes years to properly diagnose, rheumatologic conditions can become frustrating for both the provider and the patient. There are a variety of new tests available to help us establish a diagnosis, as well as multiple new and effective treatment options. This episode is part of a seven-episode mini-series on Mayo Clinic Talks dedicated to rheumatologic health problems to aid in the recognition, diagnosis, and treatment for your patients. Please find these episodes where you listen to podcasts or on ce.mayo.edu.
Rheumatoid arthritis is a chronic inflammatory, autoimmune disorder. While it typically results in a symmetric and erosive arthritis, many patients have an atypical presentation and up to 40% of those with rheumatoid arthritis have extra-articular manifestations. It tends to be progressive over years and can be quite debilitating. Fortunately, there are some new treatments available which have given our patients hope of a remission from this disease. This podcast will explore rheumatoid arthritis and we’ll discuss its clinical manifestations, how to establish a diagnosis and its management. Our guest is Vanessa L. Kronzer, M.D., from the Division of Rheumatology at the Mayo Clinic.