Definition

RA is a chronic systemic inflammatory disease of unknown etiology. It is characterized by a chronic polyarthritis affecting primarily the peripheral joints and related periarticular structures. It usually starts as an insidious symmetric polyarthritis, often with nonspecific systemic symptoms such as fatigue, low-grade temperatures, and loss of weight. It has an unpredictable and variable course and prognosis. Diagnostic and classification criteria have been proposed and are now widely used in both research and clinical practice (see Box 38.1 ).6

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