Nam et al reported a simple algorithm to evaluate and manage a patient with an early inflammatory arthritis. The goal is early diagnosis with suppression of disease activity if possible.
Patient selection: early inflammatory arthritis, non-infectious
Parameters:
(1) inflammatory arthritis
(2) duration
(3) response to corticosteroid dose
(4) evaluation for rheumatoid arthritis (RA) using the American College of Rheumatology (ACR) criteria
|
Inflammatory Arthritis |
Duration |
Response to Corticosteroid |
Evidence RA |
Group |
|
no |
NA |
NA |
NA |
1 |
|
yes |
<= 12 weeks |
no recurrent |
NA |
2 |
|
yes |
<= 12 weeks |
recurrence afterwards |
no |
3 |
|
yes |
<= 12 weeks |
recurrence afterwards |
yes |
4 |
|
yes |
> 12 weeks |
NA |
no |
3 |
|
yes |
> 12 weeks |
NA |
yes |
4 |
|
Group |
Diagnosis |
Management |
|
1 |
non-inflammatory |
Treat symptomatically, monitor. |
|
2 |
self-limiting |
Monitor. |
|
3 |
non-RA |
Diagnose type if possible, assess prognostic features, start therapy. |
|
4 |
presumed RA |
Confirm diagnosis, assess prognostic features, start therapy. |
Purpose: To evaluate a patient with early inflammatory but non-infectious arthritis based on the algorithm of Nam et al.
Specialty: Immunology/Rheumatology
Objective: criteria for diagnosis, prevention
ICD-10: M05, M06, M48.0,
