Early rheumatoid arthritis

Abstract

Reumatoidni artritis (RA) je kronična multisistemska bolest s najtežim posljedicama na sustavu za kretanje. Pravilo dobre kliničke prakse je postaviti dijagnozu RA u preerozivnoj fazi i rano primijeniti diferentne lijekove. Rana dijagnoza RA postavlja se na temelju ciljane kliničke, serološke, imunogenetske i radiološke obrade. Klinički je potrebno precizno odrediti aktivnost bolesti na temelju definiranih parametara. Reumatoidni faktor i anticitrulinska protutijela (anti-CCP) su vrlo specifični serološki parametri. Genetski biljeg HLA-DRB1* znači predispoziciju i teži oblik RA. Magnetska rezonancija i ultrazvuk pružaju velike mogućnosti otkrivanja preerozivnih promjena na kostima (edem) i perzistirajućeg sinovitisa (debljina, prokrvljenost) kada su klasični radiogrami još uredni.Rheumatoid arthritis (RA) is chronic joint disease which if untreated leads to permanent structural damage and disability. Early diagnosis and therapy are the main requests for good clinical practice. Early diagnosis tools include specific clinical assesment, serological, immunogenetic and radiological evaluation. Disease activity score is cornerstone in clinical assesment, rheumatoid factor and anti-cyclic citrullinated peptide antibodies (anti-CCP) are very specific serological parameters. The shared epitope containing HLA-DRB1* alleles represent the most significant genetic risk for RA. Magnetic resonance and ultrasound imaging are very sensitive methods in early phase of disease

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