Rheumatoid arthritis (RA) poses a diagnostic challenge in its early stages due to symptoms that are common to many other diseases. Confirming RA requires more than a single blood test or physical finding. During a physical examination, doctors look for signs like joint swelling, redness, and warmth. The treatment of RA primarily focuses on controlling synovitis and preventing joint damage. Emphasizing an early and aggressive treatment approach is crucial because joint damage, potentially leading to disability, can begin early in the disease’s course. Active disease management from the onset is important.
The primary goal of rheumatoid arthritis treatment, as per the Mayo Clinic, is to achieve the lowest level of arthritis activity, aiming for remission if possible, and to minimize joint damage while enhancing physical function and quality of life. Corticosteroids can be beneficial in early disease stages as a temporary supplementary therapy while waiting for disease-modifying antirheumatic drugs (DMARDs) to take effect.
Symptoms of early rheumatoid arthritis usually include joint stiffness, which is worse in the mornings or after periods of inactivity, along with fatigue, fever, and loss of appetite. Initially, RA tends to affect smaller joints, particularly those in the fingers and toes, and may progress to larger joints like the wrists and knees over time.
According to UpToDate, methotrexate is considered the most effective initial treatment for RA, especially in cases of moderate to high disease activity. This medication has shown a higher level of disease-modifying activity compared to other options. However, treatment approaches can vary, and doctors recommend adhering to suggested treatments early in the diagnosis to decrease symptom severity. Treatment methods for RA include a combination of medications, surgery, and lifestyle changes. Effective communication with healthcare providers is key to managing RA effectively.
