For Patients Is this Clinic for you? Rheumatoid arthritis is a chronic inflammatory arthritis that affects mainly the small joints of hands and feet. If the inflammation is not adequately controlled it can lead to joint destruction. Rheumatoid arthritis is about 3-4 times more common in women than in men and most commonly starts between the ages of 40 and 60 years. It is an autoimmune disease that mainly affects the joints but can also involve the eyes, lungs, nerves, heart, and skin. Symptoms include: Joint pain—typically, small joints of the hands, wrists, ankles, and feet are first Joint swelling—often the same joints on the both sides of the body are involved Morning stiffness—often lasting more than an hour Fatigue If these symptoms last for more than 3-4 weeks and/or do not respond to analgesics, make an appointment with your doctor. Based on his or her evaluation, your primary care physician may order more blood tests and also refer you to a rheumatologist. A rheumatologist is a doctor who specializes in the treatment of arthritis and autoimmune diseases. Please note that the Early Arthritis Clinic is dedicated to seeing patients with new onset joint symptoms, typically within 3 months of onset. If your symptoms have been present for longer, you can still be referred to one of other general rheumatology clinics. What to Expect Referral: If your primary care provider or referring physician suspects you have developed rheumatoid arthritis, please ask them to contact our office to make an appointment to the Early Arthritis Clinic. On the day of your appointment: Please arrive 15-20 minutes prior to your scheduled time. This will give you ample time to complete all the necessary paper work prior to being seen by your rheumatologist. Visit: Your physician will interview and examine you and discuss the likelihood that you have rheumatoid arthritis or other inflammatory arthritis. It is important to note that it can be difficult to diagnose rheumatoid arthritis in its early stages. Also, several other forms of joint and muscle diseases may mimic rheumatoid arthritis when they first manifest. Tests: Based on the information available to your rheumatologist and his or her suspicion for an inflammatory arthritis, you may be asked to do some blood work and/or x-rays. A positive rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) are often suggestive for rheumatoid arthritis. Additionally, blood tests may show an elevated sedimentation rate (ESR) and /or C-reactive protein (CRP) indicating the presence of an inflammatory process. X-rays are often done of hands and feet as joint damage often occurs initially in these joints. More tests: If your rheumatologist feels the need for further imaging studies, he or she may request or perform an ultrasound examination of your joints. Questionnaires: You may be asked to help fill out questionnaires to help the rheumatologist determine the extent of disease and to help follow the extent of your arthritis over the next several visit. These questionnaires may thereby provide important information about the appropriate medications for you. Follow up appointment: This will be scheduled at a time interval that will be determined by your Rheumatologist based on his/her evaluation. Research opportunities: You may also be provided information on ongoing clinical trials within the Division of Allergy, Immunology, and Rheumatology. Make an Appointment If you think you have rheumatoid arthritis, please see your primary care physician first. He or she can help determine whether you need to be referred to a rheumatologist. Your primary care physician can also help decide if you need to be referred to the Early Arthritis Clinic or to one the general clinics or other special clinics that we offer. Please note that we cannot make an appointment to the Early Arthritis Clinic without a referral from your physician.