Advances in diagnosis and treatment of rheumatic diseases

Witold Tłustochowicz

ISSN: 1505-8409

Przewodnik Lekarza/Guide for GPs

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1/2009
vol. 12

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abstract:

Advances in diagnosis and treatment of rheumatic diseases

Witold Tłustochowicz

Przew Lek 2009; 1: 153-159

Online publish date: 2009/03/18

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Chronic arthritis, due to overlap of clinical symptoms and lack of typical laboratory tests may cause diagnostic difficulties, particularly in early stages of the illness. The most important in diagnosis are anamnesis and physical examination, as well as ESR and CRP in laboratory tests. ACPA test in rheumatoid arthritis (RA) like and HLA-B27 in spondarthropathies (SpA) are useful. In early arthritis computed tomography (CT), magnetic resonance imaging (MRI) and ultrasonography (USG) plays a bigger role than X-rays. Treatment is based on corticosteroids and disease-modifying anti-rheumatic drugs (DMARD-s), particularly methotrexate. When monotherapy fails, a combination of drugs is recommended. In many patients biologics are recommended.