Arthritis, Rheumatoid


Related Terms

  • Chronic Inflammatory Arthritis
  • Proliferative Arthritis
  • RA
  • Systemic Arthritis

Differential Diagnoses

Specialists

  • Emergency Medicine Physician
  • Infectious Disease Internist
  • Internal Medicine Physician
  • Occupational Therapist
  • Orthopedic (Orthopaedic) Surgeon
  • Physiatrist
  • Physical Therapist
  • Rheumatologist

Comorbid Conditions

Factors Influencing Duration

Although some individuals have mild symptoms that resolve, most people experience progressive disease over the course of their lifetime. The individual's age, the rate of disease progression, the severity of the disease, which joints and how many joints are involved, organ system involvement, the response to treatment, and the pattern of remissions and exacerbations all affect the length of disability.

New onset cases with today's disease modifying treatment will usually be able to stay at work, while cases with onsets greater than 10 years ago may have enough destructive arthritis to be permanently unable to do heavy work.

Medical Codes

ICD-9-CM:
710.2 - Diffuse Diseases of Connective Tissue, Sicca Syndrome; Sjögrens Disease; Keratoconjunctivitis Sicca (Sicca Syndrome)
714 - Rheumatoid Arthritis and Other Inflammatory Polyarthropathies
714.0 - Rheumatoid Arthritis; Arthritis or Polyarthritis: Atrophic, Rheumatic (Chronic)
714.1 - Feltys Syndrome; Rheumatoid Arthritis with Splenoadenomegaly and Leukopenia
714.2 - Other Rheumatoid Arthritis with Visceral or Systemic Involvement; Rheumatoid Carditis
714.8 - Other Specified Inflammatory Polyarthropathies
714.81 - Rheumatoid Lung; Caplans Syndrome; Diffuse Interstitial Rheumatoid Disease of Lung; Fibrosing Alveolitis, Rheumatoid
714.89 - Other Specified Inflammatory Polyarthropathies, Other
714.9 - Unspecified Inflammatory Polyarthropathy

Failure to Recover

If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case.

Regarding diagnosis:

  • Does individual have symptoms consistent with diagnosis of RA (morning joint stiffness lasting longer than 2 hours, symmetric joint swelling and inflammation, fatigue, loss of appetite, unexplained fever, and weakness)?
  • Does individual have a family history of RA?
  • Has diagnosis of RA been confirmed through lab tests, synovial fluid analysis, x-rays?
  • Have conditions with symptoms similar to RA (such as osteoarthritis, gout, reactive arthritis, etc.) been ruled out?

Regarding treatment:

  • Is individual enrolled in a comprehensive treatment plan that allows for optimization of nonpharmacological and pharmacological therapies?
  • Does individual receive physical therapy?
  • Is individual taking medications as prescribed?
  • If individual is experiencing side effects, have alternate drug options been tried?
  • Have conservative measures been effective at reducing the symptoms and maintaining strength and mobility?

Regarding prognosis:

  • Based on the severity of the disease and the general health of individual, what is the expected outcome?
  • Has individual experienced any associated conditions or complications (such as eye dryness, pleurisy, anemia, vasculitis, neuritis, depression, fatigue, weight loss, etc) that could impact recovery and prognosis?
  • Is individual receiving counseling or treatment for the depression, anger and loss of self-esteem that can accompany the diagnosis of a chronic illness?
  • Does individual have any underlying conditions (e.g., diabetes mellitus, osteoporosis, osteoarthritis, etc.) that may impact recovery?

Source: Medical Disability Advisor


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