Smarter Decisions,
Better Care

UpToDate synthesizes the most recent medical information into evidence-based practical recommendations clinicians trust to make the right point-of-care decisions.

  • Rigorous editorial process: Evidence-based treatment recommendations
  • World-Renowned physician authors: over 5,100 physician authors and editors around the globe
  • Innovative technology: integrates into the workflow; access from EMRs

Choose from the list below to learn more about subscriptions for a:


Subscribers log in here


Evaluation and medical management of end-stage rheumatoid arthritis

INTRODUCTION

Despite the availability of methotrexate (MTX), other disease-modifying antirheumatic drugs (DMARDs), and biologic agents, some patients with rheumatoid arthritis (RA) fail to adequately respond to therapy [1]. Via a variety of mechanisms, the joints of such patients may eventually be destroyed, requiring joint arthroplasty to restore function.

This stage of the disease, termed “end-stage RA,” is characterized clinically by the following features:

Pain occurring with minimal activity and at rest

Periarticular muscle atrophy and weakness

A significant decline in functional status resulting in disability

            

Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: Jul 2014. | This topic last updated: Apr 22, 2014.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2014 UpToDate, Inc.