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Rheumatoid arthritis

Patients with rheumatoid arthritis in clinical care

J S Smolen, D Aletaha

Department of Rheumatology, Internal Medicine III, Vienna General Hospital, University of Vienna, and 2nd Department of Medicine, Lainz Hospital, Vienna, Austria

Correspondence to:
Correspondence to:
Professor J S Smolen
University of Vienna, Div of Rheumatology, Department of Internal Medicine III University of Vienna, Vienna General Hospital Vienna, A-1090, Austria; josef.smolen@wienkav.at

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The challenge of following process, damage, and function

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Keywords: damage; function; rheumatoid arthritis

The first 150 words of the full text of this article appear below.

Rheumatoid arthritis (RA) differs from most other chronic inflammatory arthropathies in its high propensity towards joint destruction.¹ The mechanisms leading to this destruction are not fully elucidated, but proinflammatory cytokines and activation of osteoclasts appear to have pivotal pathogenic roles.^2–4

The highly destructive nature of the disease is manifested by the development of erosions in 10–26% of patients with RA within 3 months from the onset of disease,^5,6 in over 60% within 1 year,⁷ and within 2 years about 75% of patients with RA have erosive joint damage.⁸ Such data are mostly derived from patients in whom a definitive diagnosis of RA had been established. However, even in a community based inception cohort of patients with inflammatory polyarthritis, who only cumulatively fulfil classification criteria for RA, the prevalence of erosive disease was 36% within 2 years.⁹ The degree of joint destruction accrues with time,^10,11 and increasing radiographic joint . . . [Full text of this article]

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