PRECLINICAL RHEUMATOID ARTHRITIS
Summary. The article presents data on the following six phases of preclinical period of the rheumatoid arthritis: genetic risk, environmental risk, development of autoimmune disorders, evident symptoms without clinical signs of arthritis, undifferentiated arthritis, and actual rheumatoid arthritis. It is well known that early treatment of rheumatoid arthritis is associated with less severe joint damage and increased chances of achieving disease-modifying antirheumatic drug-free sustained remission. That resulted into paradigm of early rheumatoid arthritis shift when a clinical manifestation of arthritis is not considered to be the beginning of the disease, but rather the culmination of well-known pathological events. The changes that occur in each phase of preclinical development for rheumatoid arthritis are analyzed in the review. Such factors as smoking, as well as autoimmune disorders, early magnetic resonance and ultrasound signs are given a special attention. The new classification criteria for arthralgia, clinically suspected rheumatoid arthritis are presented.
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