ABSTRACT
Rheumatoid arthritis This autoimmune disorder typically involves many joints and often many other body systems. Most patients have a fluctuating course that results in progressive joint destruction, deformity and disability. Inability or reduction of ability to do productive work causes economic loss to individuals and society. It affects about 0.5% of the population.1 An easily assimilated reference book, such as the ABC of Rheumatology, will help to remind you of the salient features.2 The prognosis after diagnosis is unpredictable. Some people experi ence flare-ups and remissions, others an unremitting progression. Over the years, joint deformities and functional impairment occur with structural damage to the joints. About half of those diagnosed will be disabled or unable to work after 10 years, and it shortens life expectancy.3,4
What issues you should cover Excluãng urgent conàtions When presented with acute joint pain, your most important task is to ensure that you identify serious conditions that need urgent evaluation. There are three types of condition that you do not want to miss - malignancy, bone or joint sepsis, and major vessel or nerve damage, so look out for the ‘red flags’ that suggest that one or other of these conditions may be present (see Table 7.1). In addition, check for a history of serious trauma, which can result in fractures or unstable joints.5
