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The American College of Rheumatology (ACR) developed diagnostic criteria for recognizing RA. Their list enabled determination of RA based on the presence of 4 of 7 listed criteria, and has been the standard method used by rheumatologists. These criteria include morning stiffness lasting longer than 30 minutes, arthritis in 3 or more joint areas, arthritis of hand joints, symmetric arthritis, and rheumatoid nodules. At least 4 of these criteria must have been observed by the clinician for 6 weeks after initial presentation.
However, early diagnosis and treatment in RA is vital, because a delay of as little as 4 to 6 months in treatment initiation can result in long-term joint damage. Therefore, in order to diagnose RA as early as possible, it has recently been recommended that a provisional diagnosis and referral to a rheumatologist should be made on the basis of more than 1 swollen joint in the context of other typical symptoms and signs.
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Don't Forget: Live virus vaccines should be avoided in patients on immunomodulatory therapy. These include intranasal influenza, zoster, mumps/measles/rubella, yellow fever, and
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