Interní Med. 2009; 11(7): 340-344

Highlights in diagnostics and management of rheumatoid arthritis

doc. MUDr. Radim Bečvář CSc, prof. MUDr. Karel Pavelka DrSc

Revmatologický ústav, Praha

Rheumatoid arthritis (RA) is an autoimmune disease of unknown aetiology characterized by presence of chronic synovitis which leads to

joint erosion formation. RA can start at any age and involves predominantly females (2 to 3-times). In aetiopathogenesis of RA hereditary

and external factors are involved, major role is played by so called shared epitope. Immune system is activated, tolerance is lost, and the

inflammation is localized into the joint tissues. Arthritis usually develops within weeks or months. At the same time morning stiffness

occurs with constitutional symptoms. RA may involve all joints except of distal interphalangeal joints. During the disease progression

destructions of cartilage and bone occur followed by deformities. The extraarticular manifestations include rheumatoid nodules, eye

and skin involvement, vasculitis, amyloidosis, rarely lung and heart involvement. Among the laboratory tests should be done following:

acute phase reactants, rheumatoid factor and antibodies to cyclic citrulinated peptide. Further, radiological examination is to be done,

the early morphological changes can be found using ultrasonography or MRI. In the management disease modifying drugs, glucocorticoids

and nonsteroidal antirheumatic drugs are used. So called biologicals represent novel therapeutic options. Complex therapy of

RA should also include nonpharmacological means like physiotherapy and joint surgery.

Keywords: arthritis, extraarticular manifestations, disease modifying drugs, biological therapy, nonsteroidal antirheumatic drugs.

Published: September 1, 2009  Show citation