Differential diagnosis of rheumatoid arthritis
Identifieur interne : 000832 ( Istex/Corpus ); précédent : 000831; suivant : 000833Differential diagnosis of rheumatoid arthritis
Auteurs : Allen H. MackenzieSource :
- The American Journal of Medicine [ 0002-9343 ] ; 1988.
English descriptors
- Teeft :
- American journal, Ankylosing spondylitis, Arthritis, Arthropathy, Articular, Certain features, Characteristic deformities, Chronic synovitis, Clinical history, Connective tissue disease, Differential diagnosis, Disease process, Distal interphalangeal joints, Erosive, Erosive change, Erosive changes, Erythema nodosum, Erythematosus, Erythrocyte, Erythrocyte sedimentation rate, Fibrositic syndrome, General population, Gout, Gouty tophi, Heel pain, Inflammation, Inflammatory, Interphalangeal, Joint disease, Joint involvement, Lower extremities, Lupus, Mackenzie, Medicine volume, Metacarpophalangeal joints, Metatarsophalangeal joints, Morning stiffness, Nodule, October, Osteoarthritis, Physical examination, Polymyalgia rheumatica, Proximal, Proximal interphalangeal joints, Pseudogout, Psoriasis, Psoriatic, Psoriatic arthropathy, Radiographic, Radiographic examination, Rheumatoid, Rheumatoid arthritis, Rheumatoid arthritis nodules, Rheumatoid factor, Rheumatoid nodules, Rheumatology, Sedimentation, Sedimentation rate, Spondylitis, Stiffness, Suppl, Syndrome, Synovial, Synovial fluid, Synovial fluid analysis, Synovitis, Systemic lupus erythematosus, Tophus, Upper extremities.
Abstract
Abstract: The differential diagnosis of subacute or chronic polyarthritic diseases, including rheumatoid arthritis, is based on recognizing a pattern of changes, with special emphasis placed on certain key features that possess higher specificity. The clinical history is by far the most important diagnostic tool and involves clear assessment of the distribution of joint involvement, whether pain is articular or extra-articular, whether a syndrome follows trauma or infection, and the duration of the process. The distribution of involved joints is a major contributor to differential diagnosis but can be misleading unless a skilled physical examination confirms objective synovitis. If present, nodules, which represent localization of the disease process, also offer a powerful tool in differential diagnosis. Rheumatoid nodules occur in about 20 percent of patients with well-developed rheumatoid arthritis. The effects of inflammation may be clinically detectable, but laboratory tests—e.g., the erythrocyte sedimentation rate and quantitative C-reactive protein—provide the most reliable evidence of inflammation. Synovial fluid analysis may reveal inflammatory changes and other abnormalities permitting diagnosis. Rheumatoid factor is present in about 80 percent of patients with rheumatoid arthritis but is not specific for this diagnosis.
Url:
DOI: 10.1016/0002-9343(88)90355-5
Links to Exploration step
ISTEX:A1240A9BB1C574F547084BCFDBC2127FAFBB8DA7Le document en format XML
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Mackenzie</name><affiliation><mods:affiliation>Department of Rheumatic and Immunologic Disease, The Cleveland Clinic Foundation, Cleveland, Ohio, USA</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">The American Journal of Medicine</title><title level="j" type="abbrev">AJM</title><idno type="ISSN">0002-9343</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1988">1988</date><biblScope unit="volume">85</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="supplement">S1</biblScope><biblScope unit="page" from="2">2</biblScope><biblScope unit="page" to="11">11</biblScope></imprint><idno type="ISSN">0002-9343</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0002-9343</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>American journal</term><term>Ankylosing spondylitis</term><term>Arthritis</term><term>Arthropathy</term><term>Articular</term><term>Certain features</term><term>Characteristic deformities</term><term>Chronic synovitis</term><term>Clinical history</term><term>Connective tissue disease</term><term>Differential diagnosis</term><term>Disease process</term><term>Distal interphalangeal joints</term><term>Erosive</term><term>Erosive change</term><term>Erosive changes</term><term>Erythema nodosum</term><term>Erythematosus</term><term>Erythrocyte</term><term>Erythrocyte sedimentation rate</term><term>Fibrositic syndrome</term><term>General population</term><term>Gout</term><term>Gouty tophi</term><term>Heel pain</term><term>Inflammation</term><term>Inflammatory</term><term>Interphalangeal</term><term>Joint disease</term><term>Joint involvement</term><term>Lower extremities</term><term>Lupus</term><term>Mackenzie</term><term>Medicine volume</term><term>Metacarpophalangeal joints</term><term>Metatarsophalangeal joints</term><term>Morning stiffness</term><term>Nodule</term><term>October</term><term>Osteoarthritis</term><term>Physical examination</term><term>Polymyalgia rheumatica</term><term>Proximal</term><term>Proximal interphalangeal joints</term><term>Pseudogout</term><term>Psoriasis</term><term>Psoriatic</term><term>Psoriatic arthropathy</term><term>Radiographic</term><term>Radiographic examination</term><term>Rheumatoid</term><term>Rheumatoid arthritis</term><term>Rheumatoid arthritis nodules</term><term>Rheumatoid factor</term><term>Rheumatoid nodules</term><term>Rheumatology</term><term>Sedimentation</term><term>Sedimentation rate</term><term>Spondylitis</term><term>Stiffness</term><term>Suppl</term><term>Syndrome</term><term>Synovial</term><term>Synovial fluid</term><term>Synovial fluid analysis</term><term>Synovitis</term><term>Systemic lupus erythematosus</term><term>Tophus</term><term>Upper extremities</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Abstract: The differential diagnosis of subacute or chronic polyarthritic diseases, including rheumatoid arthritis, is based on recognizing a pattern of changes, with special emphasis placed on certain key features that possess higher specificity. The clinical history is by far the most important diagnostic tool and involves clear assessment of the distribution of joint involvement, whether pain is articular or extra-articular, whether a syndrome follows trauma or infection, and the duration of the process. The distribution of involved joints is a major contributor to differential diagnosis but can be misleading unless a skilled physical examination confirms objective synovitis. If present, nodules, which represent localization of the disease process, also offer a powerful tool in differential diagnosis. Rheumatoid nodules occur in about 20 percent of patients with well-developed rheumatoid arthritis. The effects of inflammation may be clinically detectable, but laboratory tests—e.g., the erythrocyte sedimentation rate and quantitative C-reactive protein—provide the most reliable evidence of inflammation. Synovial fluid analysis may reveal inflammatory changes and other abnormalities permitting diagnosis. Rheumatoid factor is present in about 80 percent of patients with rheumatoid arthritis but is not specific for this diagnosis.</div></front></TEI><istex><corpusName>elsevier</corpusName><keywords><teeft><json:string>rheumatoid</json:string><json:string>rheumatoid arthritis</json:string><json:string>nodule</json:string><json:string>rheumatoid factor</json:string><json:string>synovitis</json:string><json:string>synovial</json:string><json:string>osteoarthritis</json:string><json:string>interphalangeal</json:string><json:string>erythrocyte</json:string><json:string>mackenzie</json:string><json:string>arthritis</json:string><json:string>erythrocyte sedimentation rate</json:string><json:string>radiographic</json:string><json:string>spondylitis</json:string><json:string>articular</json:string><json:string>october</json:string><json:string>american journal</json:string><json:string>tophus</json:string><json:string>lupus</json:string><json:string>inflammatory</json:string><json:string>synovial fluid</json:string><json:string>erythematosus</json:string><json:string>erosive</json:string><json:string>suppl</json:string><json:string>psoriasis</json:string><json:string>medicine volume</json:string><json:string>differential diagnosis</json:string><json:string>arthropathy</json:string><json:string>pseudogout</json:string><json:string>disease process</json:string><json:string>psoriatic</json:string><json:string>rheumatology</json:string><json:string>rheumatoid nodules</json:string><json:string>systemic lupus erythematosus</json:string><json:string>lower extremities</json:string><json:string>radiographic examination</json:string><json:string>distal interphalangeal joints</json:string><json:string>sedimentation rate</json:string><json:string>psoriatic arthropathy</json:string><json:string>joint disease</json:string><json:string>sedimentation</json:string><json:string>syndrome</json:string><json:string>inflammation</json:string><json:string>ankylosing spondylitis</json:string><json:string>joint involvement</json:string><json:string>metacarpophalangeal joints</json:string><json:string>fibrositic syndrome</json:string><json:string>physical examination</json:string><json:string>general population</json:string><json:string>proximal interphalangeal joints</json:string><json:string>rheumatoid arthritis nodules</json:string><json:string>stiffness</json:string><json:string>connective tissue disease</json:string><json:string>erosive change</json:string><json:string>morning stiffness</json:string><json:string>heel pain</json:string><json:string>certain features</json:string><json:string>erosive changes</json:string><json:string>clinical history</json:string><json:string>metatarsophalangeal joints</json:string><json:string>characteristic deformities</json:string><json:string>chronic synovitis</json:string><json:string>upper extremities</json:string><json:string>gouty tophi</json:string><json:string>synovial fluid analysis</json:string><json:string>erythema nodosum</json:string><json:string>polymyalgia rheumatica</json:string><json:string>gout</json:string><json:string>proximal</json:string></teeft></keywords><author><json:item><name>Allen H. 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The distribution of involved joints is a major contributor to differential diagnosis but can be misleading unless a skilled physical examination confirms objective synovitis. If present, nodules, which represent localization of the disease process, also offer a powerful tool in differential diagnosis. Rheumatoid nodules occur in about 20 percent of patients with well-developed rheumatoid arthritis. The effects of inflammation may be clinically detectable, but laboratory tests—e.g., the erythrocyte sedimentation rate and quantitative C-reactive protein—provide the most reliable evidence of inflammation. Synovial fluid analysis may reveal inflammatory changes and other abnormalities permitting diagnosis. 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Mackenzie, Department of Rheumatic and Immunologic Disease, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44106.</note><affiliation>Requests for reprints should be addressed to Dr. Allen H. Mackenzie, Department of Rheumatic and Immunologic Disease, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44106.</affiliation><affiliation>Department of Rheumatic and Immunologic Disease, The Cleveland Clinic Foundation, Cleveland, Ohio, USA</affiliation></author><idno type="istex">A1240A9BB1C574F547084BCFDBC2127FAFBB8DA7</idno><idno type="ark">ark:/67375/6H6-G89BRMRT-V</idno><idno type="DOI">10.1016/0002-9343(88)90355-5</idno><idno type="PII">0002-9343(88)90355-5</idno><idno type="article-id">88903555</idno></analytic><monogr><title level="j">The American Journal of Medicine</title><title level="j" type="abbrev">AJM</title><idno type="pISSN">0002-9343</idno><idno type="PII">S0002-9343(00)X0914-X</idno><meeting><addName>Update in Rheumatology: Focus on Hydroxychloroquine, Hyatt Regency Cerromar Beach, Dorado, Puerto Rico</addName><date>19871210</date><date>19871211</date></meeting><editor xml:id="book-author-0000"><persName>Nathan J. Zvaifler</persName></editor><editor xml:id="book-author-0001"><persName>M.D.</persName></editor><imprint><publisher>ELSEVIER</publisher><date type="published" when="1988"></date><biblScope unit="volume">85</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="supplement">S1</biblScope><biblScope unit="page" from="2">2</biblScope><biblScope unit="page" to="11">11</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1988</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Abstract: The differential diagnosis of subacute or chronic polyarthritic diseases, including rheumatoid arthritis, is based on recognizing a pattern of changes, with special emphasis placed on certain key features that possess higher specificity. The clinical history is by far the most important diagnostic tool and involves clear assessment of the distribution of joint involvement, whether pain is articular or extra-articular, whether a syndrome follows trauma or infection, and the duration of the process. The distribution of involved joints is a major contributor to differential diagnosis but can be misleading unless a skilled physical examination confirms objective synovitis. If present, nodules, which represent localization of the disease process, also offer a powerful tool in differential diagnosis. Rheumatoid nodules occur in about 20 percent of patients with well-developed rheumatoid arthritis. The effects of inflammation may be clinically detectable, but laboratory tests—e.g., the erythrocyte sedimentation rate and quantitative C-reactive protein—provide the most reliable evidence of inflammation. Synovial fluid analysis may reveal inflammatory changes and other abnormalities permitting diagnosis. Rheumatoid factor is present in about 80 percent of patients with rheumatoid arthritis but is not specific for this diagnosis.</p></abstract></profileDesc><revisionDesc><change when="1988">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/6H6-G89BRMRT-V/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier, elements deleted: tail"><istex:xmlDeclaration>version="1.0" encoding="UTF-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 4.5.2//EN//XML" URI="art452.dtd" name="istex:docType"></istex:docType><istex:document><converted-article version="4.5.2" docsubtype="fla" xml:lang="en"><item-info><jid>AJM</jid><aid>88903555</aid><ce:pii>0002-9343(88)90355-5</ce:pii><ce:doi>10.1016/0002-9343(88)90355-5</ce:doi><ce:copyright type="unknown" year="1988"></ce:copyright></item-info><head><ce:title>Differential diagnosis of rheumatoid arthritis</ce:title><ce:author-group><ce:author><ce:given-name>Allen H.</ce:given-name><ce:surname>Mackenzie</ce:surname><ce:degrees>m.D.</ce:degrees><ce:cross-ref refid="COR1"><ce:sup loc="post">∗</ce:sup></ce:cross-ref></ce:author><ce:affiliation><ce:textfn>Department of Rheumatic and Immunologic Disease, The Cleveland Clinic Foundation, Cleveland, Ohio, USA</ce:textfn></ce:affiliation><ce:correspondence id="COR1"><ce:label>∗</ce:label><ce:text>Requests for reprints should be addressed to Dr. Allen H. Mackenzie, Department of Rheumatic and Immunologic Disease, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44106.</ce:text></ce:correspondence></ce:author-group><ce:abstract class="author"><ce:section-title>Abstract</ce:section-title><ce:abstract-sec><ce:simple-para view="all" id="simple-para.0010">The differential diagnosis of subacute or chronic polyarthritic diseases, including rheumatoid arthritis, is based on recognizing a pattern of changes, with special emphasis placed on certain key features that possess higher specificity. The clinical history is by far the most important diagnostic tool and involves clear assessment of the distribution of joint involvement, whether pain is articular or extra-articular, whether a syndrome follows trauma or infection, and the duration of the process. The distribution of involved joints is a major contributor to differential diagnosis but can be misleading unless a skilled physical examination confirms objective synovitis. If present, nodules, which represent localization of the disease process, also offer a powerful tool in differential diagnosis. Rheumatoid nodules occur in about 20 percent of patients with well-developed rheumatoid arthritis. The effects of inflammation may be clinically detectable, but laboratory tests—e.g., the erythrocyte sedimentation rate and quantitative C-reactive protein—provide the most reliable evidence of inflammation. Synovial fluid analysis may reveal inflammatory changes and other abnormalities permitting diagnosis. Rheumatoid factor is present in about 80 percent of patients with rheumatoid arthritis but is not specific for this diagnosis.</ce:simple-para></ce:abstract-sec></ce:abstract></head></converted-article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Differential diagnosis of rheumatoid arthritis</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Differential diagnosis of rheumatoid arthritis</title></titleInfo><name type="personal"><namePart type="given">Allen H.</namePart><namePart type="family">Mackenzie</namePart><namePart type="termsOfAddress">m.D.</namePart><affiliation>Department of Rheumatic and Immunologic Disease, The Cleveland Clinic Foundation, Cleveland, Ohio, USA</affiliation><description>Requests for reprints should be addressed to Dr. Allen H. Mackenzie, Department of Rheumatic and Immunologic Disease, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44106.</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">1988</dateIssued><copyrightDate encoding="w3cdtf">1988</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><abstract lang="en">Abstract: The differential diagnosis of subacute or chronic polyarthritic diseases, including rheumatoid arthritis, is based on recognizing a pattern of changes, with special emphasis placed on certain key features that possess higher specificity. The clinical history is by far the most important diagnostic tool and involves clear assessment of the distribution of joint involvement, whether pain is articular or extra-articular, whether a syndrome follows trauma or infection, and the duration of the process. The distribution of involved joints is a major contributor to differential diagnosis but can be misleading unless a skilled physical examination confirms objective synovitis. If present, nodules, which represent localization of the disease process, also offer a powerful tool in differential diagnosis. Rheumatoid nodules occur in about 20 percent of patients with well-developed rheumatoid arthritis. The effects of inflammation may be clinically detectable, but laboratory tests—e.g., the erythrocyte sedimentation rate and quantitative C-reactive protein—provide the most reliable evidence of inflammation. Synovial fluid analysis may reveal inflammatory changes and other abnormalities permitting diagnosis. Rheumatoid factor is present in about 80 percent of patients with rheumatoid arthritis but is not specific for this diagnosis.</abstract><relatedItem type="host"><titleInfo><title>The American Journal of Medicine</title></titleInfo><titleInfo type="abbreviated"><title>AJM</title></titleInfo><name type="conference"><namePart>Update in Rheumatology: Focus on Hydroxychloroquine, Hyatt Regency Cerromar Beach, Dorado, Puerto Rico</namePart><namePart type="date">19871210</namePart><namePart type="date">19871211</namePart></name><name type="personal"><namePart>Nathan J. Zvaifler</namePart><role><roleTerm type="text">editor</roleTerm></role></name><name type="personal"><namePart>M.D.</namePart><role><roleTerm type="text">editor</roleTerm></role></name><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">1988</dateIssued></originInfo><identifier type="ISSN">0002-9343</identifier><identifier type="PII">S0002-9343(00)X0914-X</identifier><part><date>1988</date><detail type="issue"><title>Update in Rheumatology: Focus on Hydroxychloroquine, Hyatt Regency Cerromar Beach, Dorado, Puerto Rico</title></detail><detail type="volume"><number>85</number><caption>vol.</caption></detail><detail type="issue"><number>4</number><caption>no.</caption></detail><detail type="supplement"><number>S1</number><caption>Suppl.</caption></detail><extent unit="issue-pages"><start>1</start><end>71</end></extent><extent unit="pages"><start>2</start><end>11</end></extent></part></relatedItem><identifier type="istex">A1240A9BB1C574F547084BCFDBC2127FAFBB8DA7</identifier><identifier type="ark">ark:/67375/6H6-G89BRMRT-V</identifier><identifier type="DOI">10.1016/0002-9343(88)90355-5</identifier><identifier type="PII">0002-9343(88)90355-5</identifier><identifier type="ArticleID">88903555</identifier><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-HKKZVM7B-M">elsevier</recordContentSource></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/ark:/67375/6H6-G89BRMRT-V/record.json</uri></json:item></metadata></istex></record>Pour manipuler ce document sous Unix (Dilib)
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