title: Rheumatoid arthritis.
abstract: BACKGROUND
  Rheumatoid arthritis is a chronic disease that can cause irreversible joint damage and significant disability. With a prevalence of 1%, it has a considerable cost to the community. Diagnosis is based on a combination of clinical and laboratory features. Patients typically present with a symmetrical polyarthritis of the small joints of the hands and feet accompanied by early morning stiffness and, occasionally, constitutional symptoms.
  
  
  OBJECTIVE
  This review discusses the role of the general practitioner in the diagnosis and early management of rheumatoid arthritis.
  
  
  CONCLUSIONS
  It is increasingly recognised that there is a 'window of opportunity' within which disease modifying antirheumatic drug therapy should be commenced to arrest progressive disease and joint destruction. Methotrexate is usually the first line agent in the management of rheumatoid arthritis but simple analgesia and nonsteroidal anti-inflammatory drugs are also important for symptom control.
authors.affiliation: Department of Rheumatology, Royal Melbourne Hospital, Melbourne, Victoria. genesiew@excite.com
authors.forename: Gene-Siew
authors.initials: GS
authors.lastname: Ngian
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D001315:Australia / Q000453:epidemiology; D015415:Biomarkers; D003937:Diagnosis, Differential; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use; D006801:Humans; D017410:Practice Guidelines as Topic
chemical_list: D000305:Adrenal Cortex Hormones; D018501:Antirheumatic Agents; D015415:Biomarkers; D015525:Fatty Acids, Omega-3