TITLE:
A Focus on the Diagnosis of Early Rheumatoid Arthritis
AUTHORS:
Marta Olivieri, Maria Chiara Gerardi, Francesca Romana Spinelli, Manuela Di Franco
KEYWORDS:
Early Rheumatoid Arthritis; Diagnosis
JOURNAL NAME:
International Journal of Clinical Medicine,
Vol.3 No.7,
December
31,
2012
ABSTRACT: Nowadays it is worldwide accepted
that early diagnosis and early treatment of Rheumatoid Arthritis (RA) can
improve the prognosis in most of patients. In this way, the 2010 ACR/EULAR
Rheumatoid Arthritis classification criteria have shown to be more sensitive
than the ACR 1987 criteria and include better patients with early RA. Other important point to focus on is
to identify predictive
factors for outcome, in order to propose a more aggressive treatment for early RA patients who could
develop a persistent
and/or erosive disease. The presence of Rheumatoid Factors (RF) and Anti- citrullinated peptides antibobies (ACPA), as well as the duration of the disease at the time of
diagnosis, are independent risk factors for the development of erosive RA. As for imaging, both traditional X-ray
and Magnetic Resonance Imaging (MRI) highlight respectively the Rapid
Radiological Progression (RRP) and the presence of bone edema which are associated
to a more aggressive disease. In the last years, the musculoskeletal ultrasonography (MSUS) has
emerged as a useful imaging technique since it allows to identify synovitis and bone alteration earlier than the
radiological examination. Interating clinical, serological and imaging data the clinician can define the effective disease
activity of each patient.