Rheumatoid Arthritis
This autoantibody is more specific than rheumatoid factor for diagnosing rheumatoid arthritis.
What is anti-cyclic citrullinated peptide (anti-CCP)?
This medication is first-line for an acute gout flare in a patient with normal renal function, alongside NSAIDs and steroids.
What is colchicine?
This organ is the most commonly involved in systemic sclerosis, with the hands universally affected in all patients.
What is the skin?
This autoantibody, together with a history of a culprit medication like hydralazine, procainamide, or isoniazid, characterizes drug-induced lupus, which typically spares the kidneys and CNS.
What are antihistone antibodies?
Unlike osteoarthritis, this joint group is typically spared in rheumatoid arthritis, though it can be involved in psoriatic arthritis.
What are the distal interphalangeal (DIP) joints?
Before starting a TNF-alpha inhibitor for RA, this infection must be screened for and treated if latent.
What is tuberculosis?
This class of urate-lowering therapy must only be started after an acute gout flare has fully resolved, not during one.
What are xanthine oxidase inhibitors (e.g., allopurinol, febuxostat)?
This subtype of systemic sclerosis is limited to skin thickening of the face, neck, hands, and feet (sparing proximal skin), typically lacks internal organ fibrosis, and is more commonly associated with this pulmonary vascular complication rather than interstitial lung disease.
What is LcSSc and pulmonary arterial hypertension?
This autoantibody is highly specific (about 99%) for SLE, but has low sensitivity and, unlike anti-dsDNA, does not correlate with disease activity.
What is anti-Smith (anti-Sm) antibody?
This is the most appropriate initial imaging study for evaluating suspected knee osteoarthritis.
What is radiography?
This rare complication of longstanding, severe seropositive RA presents with a triad of RA, splenomegaly, and neutropenia.
What is Felty syndrome?
This interleukin-1β inhibitor is FDA-approved for treating gout flares when colchicine, glucocorticoids, and NSAIDs are contraindicated, not tolerated, or ineffective, and is given as a single subcutaneous dose that can only be repeated after 12 weeks.
What is canakinumab?
In patients with systemic sclerosis, this class of medication is first-line treatment once scleroderma renal crisis develops.
What are ACE-inhibitors?
In a patient with SLE and suspected active lupus nephritis — evidenced by active urine sediment, proteinuria over 500 mg/24h, rising anti-dsDNA titers, and low complement levels — this is the most appropriate next diagnostic step to confirm the diagnosis and guide treatment.
What is kidney biopsy?
In a patient with symptomatic, radiographic moderate-to-severe knee or hip OA who has already tried conservative measures like physical therapy, weight loss, and medications without relief, the 2023 ACR/AAHKS guideline supports proceeding directly to this intervention rather than continuing to trial additional treatments first.
What is total knee replacement?
Concomitant use of this DMARD with xanthine oxidase inhibitors is relatively contraindicated because of increased risk of myelosuppression.
What is azathioprine?
Before starting this urate-lowering medication, guidelines recommend genetic testing for this HLA allele in patients of Southeast or East Asian (e.g., Han Chinese, Thai, Korean) or African descent, given their increased risk of a rare, life-threatening hypersensitivity reaction.
What are allopurinol and HLA-B*58:01?
This gastrointestinal complication of systemic sclerosis, associated with diffuse disease and anti-RNA polymerase III antibody positivity, causes chronic GI blood loss and has a characteristic endoscopic appearance of dilated blood vessels in the stomach.
What is GAVE (gastric antral vascular ectasia)?
This monoclonal antibody targets B-lymphocyte stimulator (BLyS/BAFF) and is FDA-approved for active, autoantibody-positive SLE, including lupus nephritis.
What is belimumab?
Current guidelines conditionally recommend against this commonly used intra-articular injectable for knee OA, given inconsistent evidence of benefit despite its widespread use.
What is hyaluronic acid?
A patient with rheumatoid arthritis on methotrexate develops an increase in the size and number of subcutaneous rheumatoid nodules despite improving joint symptoms — a paradoxical phenomenon known as accelerated nodulosis. This is the recommended next step in management.
What is switching to a different DMARD?
This destructive shoulder arthropathy, seen in elderly women, is caused by basic calcium phosphate crystal deposition and combines rotator cuff tearing with joint destruction.
What is Milwaukee shoulder syndrome?
For interstitial lung disease in systemic sclerosis, this medication is favored over cyclophosphamide as first-line, long-term therapy, offering comparable improvement in FVC and skin thickening with a better safety profile.
What is mycophenolate mofetil?
Per the revised Sapporo (Sydney) classification criteria, diagnosing antiphospholipid syndrome requires a clinical criterion plus antiphospholipid antibodies confirmed positive on two occasions, at least this many weeks apart.
What is 12 weeks?
The ACR strongly recommends this mind-body exercise practice for knee and hip osteoarthritis, with evidence showing it's as beneficial as physical therapy for knee OA pain.
What is tai chi?