Article

Evaluating patients with arthritis of recent onset: studies in pathogenesis and prognosis.

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JAMA The Journal of the American Medical Association (impact factor: 30.03). 12/2000; 284(18):2368-73. DOI:10.1001/jama.284.18.2368 pp.2368-73
Source: PubMed

ABSTRACT Inflammatory synovitis of recent onset poses a diagnostic and prognostic challenge to primary care physicians and rheumatologists. A lack of understanding of the underlying etiologic and pathogenic processes limits the ability to distinguish forms of arthritis that follow a benign, self-limiting course from forms that proceed to an aggressive, erosive disease requiring intensive immunosuppressive therapy. It is estimated that between 30% and 40% of patients presenting with early synovitis have disease that remains unclassified. Using data from a cohort of patients with early synovitis and reviewing current literature, we discuss investigational approaches toward a new classification of patients with early synovitis. Although a lack of understanding of this heterogeneous clinical syndrome has led clinicians to take a largely empirical approach to treatment thus far, the evolving awareness of disease predisposition at a genetic level and the expanding ability to specifically manipulate biological pathways may ultimately change the approach to this clinical problem. JAMA. 2000;284:2368-2373.

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Keywords

current literature
 
disease predisposition
 
distinguish forms
 
empirical approach
 
erosive disease
 
evolving awareness
 
expanding ability
 
genetic level
 
heterogeneous clinical syndrome
 
Inflammatory synovitis
 
investigational approaches
 
manipulate biological pathways
 
new classification
 
pathogenic processes limits
 
primary care physicians
 
prognostic challenge
 
recent onset
 
remains unclassified
 
self-limiting course
 
underlying etiologic
 

H S El-Gabalawy