<unk>  is a chronic inflammatory systemic disease which is found commonly in women and starts in mid 30's to 40's. Cause of<unk>  is idiopathic but there are genetic factors such as  HLA-DR4 cluster, environmental factors like smoking, hormonal factors like hyperprolactinemia, infectious factors like mycoplasma, epstein-Barr virus (EBV), rubella virus, porphyromonas gingivalis, socioeconomic, psychological, and lifestyle factors such as obesity play important role in the development of<unk> . There is no established system for the classification of<unk> . Depending on the presentation of<unk> , it is classified into typical classic<unk>  and palindromic rheumatism.  Common symptoms of<unk>  are joint pain of small joints of the hands, wrist, and forefoot, joint swelling, morning joint stiffness classically lasting for more than an hour, decreased grip strength, generalized aching, and fatigue, weight loss, depression. Less common symptoms are tingling and numbness in the arm and weakness in the arm. Anti-CCP antibodies testing is the gold standard test for the diagnosis of<unk> .It has the specificity of about 81-100%, with the sensitivity of 39–94%. Hallmark of<unk>  Xray findings are soft tissue swelling, joint space narrowing, and erosions but it involves small joints with multiple deformities. Findings on an ultrasound suggestive of<unk>  are tenosynovitis, bursitis, baker's cyst and inflammation of synovium. Therapeutic use of ultrasound is the guidance of corticosteroid injection in the joint and fluid aspiration from the joint effusion. MRI is helpful in the diagnosis of early and subacute<unk> . Findings on MRI diagnostic of<unk>  are synovial hyperemia, synovial hyperplasia, pannus, subchondral cysts, erosions, effusion of joints and bone marrow edema. The mainstay of treatment of<unk>  is pharmacotherapy.  There are two types of therapies- non-pharmacological therapy and pharmacological therapy. There are different drug regimen depending upon the stage of the disease. In active stage, combined therapy include disease-modifying antirheumatic drugs (DMARDs) are used along with the anti-inflammatory drugs. Therapy for resistant disease and flares is the addition of oral glucocorticoids. In case of the flare, add another DMARDs with methotrexate or replace with another DMARDs. Surgery is usually reserved for patients with debilitating disease, failure of medical therapy and<unk> diographic findings of end-stage arthritis. Various surgical options used for the treatment of<unk>  are tenosynovectomy, arthroscopic or open synovectomy, joint fusion, small joint implant arthroplasty, total joint replacement of deformed joint. Effective measures for the primary prevention of<unk>  are patient education, exercise, physical and occupational therapy and cognitive behavioral therapies. Effective measures for the secondary prevention of<unk>  are calcium and vitamin D supplementation to prevent osteoporosis. To prevent cardiovascular complications and recurrent attacks of<unk> , effective methods are exercise, smoking cessation, and dietary control.
Rheumatoid arthritis
Reactive arthritis
Psoriatic arthritis
Crystal arthritis
Oligoarthritis
Enteropathic arthropathy
Juvenile idiopathic arthritis
Osteoarthritis