Table Of ContentFFrroonntt
CCoovveerr 11
EEddiittoorrss aanndd AAuutthhoorrss 33
DDeeddiiccaattiioonn 1166
FFoorreewwoorrdd 1177
PPrreeffaaccee 2200
AAcckknnoowwlleeddggmmeennttss 2233
II -- CClliinniiccaall,, LLaabboorraattoorryy,, aanndd RRaaddiioollooggiicc FFeeaattuurreess
11 -- EEppiiddeemmiioollooggyy 2244
22 -- CClliinniiccaall FFeeaattuurreess aanndd DDiiffffeerreennttiiaall DDiiaaggnnoossiiss 6677
33 -- PPrrooggnnoossiiss aanndd CClliinniiccaall CCoouurrssee 111155
44 -- SSeellff--RReeppoorrtt QQuueessttiioonnnnaaiirreess iinn CClliinniiccaall CCaarree 117755
55 -- CClliinniiccaall aanndd LLaabboorraattoorryy MMeeaassuurreess 220066
66 -- AAuuttooaannttiibbooddiieess aanndd OOtthheerr LLaabboorraattoorryy TTeessttss 224499
77 -- RRaaddiiooggrraapphhiicc FFiinnddiinnggss 331100
88 -- MMeeaassuurreemmeenntt ooff RRaaddiioollooggiicc OOuuttccoommeess 333388
99 -- UUllttrraassoonnooggrraapphhyy aanndd MMRRII ffoorr DDiiaaggnnoossiiss aanndd MMaannaaggeemmeenntt 336622
IIII -- PPaatthhooggeenneessiiss
1100 -- GGeenneettiicc DDeetteerrmmiinnaannttss 339933
1111 -- PPaatthhoollooggyy 443355
1122 -- RRoollee ooff CCyyttookkiinneess 448811
1133 -- AAnnggiiooggeenneessiiss aanndd LLeeuukkooccyyttee RReeccrruuiittmmeenntt 553322
1144 -- NNeeuuttrroopphhiillss aanndd SSmmaallll MMoolleeccuullee MMeeddiiaattoorrss 557722
1155 -- CCoommpplleemmeenntt aanndd OOtthheerr AAssppeeccttss ooff IInnnnaattee IImmmmuunniittyy 662266
1166 -- TT CCeellllss iinn tthhee PPaatthhooggeenneessiiss ooff RRhheeuummaattooiidd AArrtthhrriittiiss 665555
1177 -- AAuuttooiimmmmuunniittyy 669977
1188 -- IImmmmuunnoosseenneesscceennccee aanndd TT--CCeellll BBiioollooggyy iinn RRhheeuummaattooiidd AArrtthhrriittiiss 775577
1199 -- SSyynnoovviiaall FFiibbrroobbllaassttss 779933
2200 -- CCaarrttiillaaggee aanndd BBoonnee DDeeggrraaddaattiioonn 882233
2211 -- MMeecchhaanniissmmss ooff JJooiinntt DDaammaaggee iinn RRhheeuummaattooiidd AArrtthhrriittiiss 886622
2222 -- AAnniimmaall MMooddeellss 990066
IIIIII -- TThheerraappyy
2233 -- NNoonnsstteerrooiiddaall AAnnttiiiinnffllaammmmaattoorryy DDrruuggss aanndd AAnnaallggeessiiccss 995511
2244 -- CCoorrttiiccoosstteerrooiiddss 999933
2255 -- MMeetthhoottrreexxaattee aanndd AAzzaatthhiioopprriinnee 11004422
2266 -- SSuullffaassaallaazziinnee 11008855
2277 -- GGoolldd CCoommppoouunnddss aanndd AAnnttiimmaallaarriiaallss 11111155
2288 -- MMiinnooccyycclliinnee 11114477
2299 -- CCyycclloossppoorriinnee 11117744
3300 -- LLeefflluunnoommiiddee 11221100
31 - Etanercept 1234
32 - Antibodies to Tumor Necrosis Factor alpha - Infliximab and Adalimumab 1257
33 - Anakinra, Interleukin-1 Receptor Antagonist 1299
34 - Staphylococcal Protein A Columns 1329
35 - Combination Disease-Modifying Antirheumatic Drug Therapy 1352
36 - Treatment of Early Disease 1380
37 - Cognitive-Behavioral Therapy 1397
38 - Physical Therapy 1427
39 - Occupational Therapy 1446
40 - Medical Aspects of Surgery 1473
41 - Total Joint Arthroplasty 1505
42 - Hand and Wrist Surgery 1529
43 - Foot and Ankle Surgery 1555
44 - Cervical Spine Surgery 1582
45 - Extraarticular Disease 1608
IV - Special Management Issues
46 - Pregnancy 1650
47 - Osteoporosis 1679
48 - Depression 1724
Appendices
A - 1987 Revised Criteria for the Classification of Rheu matoid Arthritis, Traditional Format 1754
B - American College of Rheumatology Preliminary Definition of Improvement in Rheumatoid Arthritis 1756
C - Paulus Criteria for Improvement of Patients with Rheumatoid Arthritis 1758
D - Disease Activity Score, Disease Activity Score 28, and European League Against Rheumatism Response Criteria 1759
E - Clinical Health Assessment Questionnaire 1763
F - Clinical Health Assessment Questionnaire II 1768
Rheumatoid Arthritis
by E. William St. Clair
Rheumatoid Arthritis are thoroughly covered in order
to provide a firm foundation for the main focus of the
text: therapy and clinical management of the disease
Contents
Clinical, Laboratory, and Radiologic Features
1. Epidemiology
2. Clinical Features and Differential Diagnosis
3. Prognosis and Clinical Course
4. Self-Report Questionnaires in Clinical Care
5. Clinical and Laboratory Measures
6. Autoantibodies and Other Laboratory Tests
7. Radiographic Findings
8. Measurement of Radiologic Outcomes
9. Ultrasonography and Magnetic Resonance Imaging for Diagnosis and Management
Pathogenesis
10. Genetic Determinants
11. Pathology
12. Role of Cytokines
13. Angiogenesis and Leukocyte Recruitment
14. Neutrphils and Small Molecule Mediators
15. Complement and Other Aspects of Innate Immunity
16. T Cells in the Pathogenesis of Rheumatoid Arthritis
17. Autoimmunity
18. Immunosenescence and T-Cell Biology in Rheumatoid Arthritis
19. Synovial Fibroblasts
20. Cartilage and Bone Degradation
21. Mechanisms of Joint Damage in Rheumatoid Arthritis
22. Animal Models
Therapy
23. Nonsteroidal Antiinflammatory Drugs and Analgesics
24. Corticosteroids
25. Methotrexate and Azathioprine
26. Sulfasalazine
27. Gold Compounds and Antimalarials
28. Minocycline
29. Cyclosporine
30.
31.
32.
27.
28.
29.
30. Leflunomide
31. Etanercept
32. Antibodies to Tumor Necrosis Factor: Infliximab and Adalimumab
33. Anakinra
34. Staphylococcal Protein A Columns
35. Combination Disease-Modifying Antirheumatic Drug Therapy
36. Treatment of Early Disease
37. Cognitive-Behavioral Therapy
38. Physical Therapy
39. Occupational Therapy
40. Medical Aspects of Surgery
41. Total Joints Arthroplasty
42. Hand and Wrist Surgery
43. Foot and Ankle Surgery
44. Cervical Spine Surgery
Special Management Issues
45. Extraarticular Disease
46. Pregnancy
47. Osteoporosis
48. Depression
Editors: St. Clair, E. William; Pisetsky, David S.; Haynes, Barton F.
Title: Rheumatoid Arthritis, 1st Edition
Copyright ©2004 Lippincott Williams & Wilkins
> Front of Book > Editors
EDITORS
E. William St. Clair MD
PROFESSOR OF MEDICINE AND IMMUNOLOGY
DEPARTMENTS OF MEDICINE AND IMMUNOLOGY, DIVISION OF RHEUMATOLOGY
AND IMMUNOLOGY, DUKE UNIVERSITY MEDICAL CENTER, DURHAM, NORTH
CAROLINA
David S. Pisetsky MD, PHD
PROFESSOR OF MEDICINE AND IMMUNOLOGY
DEPARTMENTS OF MEDICINE AND IMMUNOLOGY, DIVISION OF RHEUMATOLOGY
AND IMMUNOLOGY; CHIEF OF RHEUMATOLOGY AND IMMUNOLOGY, DUKE
UNIVERSITY MEDICAL CENTER, DURHAM VA MEDICAL CENTER, DURHAM, NORTH
CAROLINA
Barton F. Haynes MD
FREDERIC M. HANES PROFESSOR OF MEDICINE; PROFESSOR OF IMMUNOLOGY
DEPARTMENTS OF MEDICINE AND IMMUNOLOGY, DUKE UNIVERSITY SCHOOL OF
MEDICINE; DIRECTOR, HUMAN VACCINE INSTITUTE, DUKE UNIVERSITY MEDICAL
CENTER, DURHAM, NORTH CAROLINA
WITH CONTRIBUTING AUTHORS
Secondary Editors
Danette Somers
Acquisitions Editor
Lisa Consoli
Developmental Editor
Mary Ann McLaughlin
Supervising Editor
Kate Sallwasser
Production Editor
Silverchair Science + Communications
Colin Warnock
Manufacturing Manager
Brian Crede
Cover Designer
Compositor: Silverchair Science + Communications
Printer: Quebecor World-Kingsport
Contributing Authors
Steven B. Abramson MD
Professor of Medicine and Pathology
Department of Medicine, Division of Rheumatology, New York University School
of Medicine, New York, New York
Graciela S. Alarc ³n MD, MPH
Jane Knight Lowe Chair of Medicine in Rheumatology
Department of Medicine, Division of Clinical Immunology and Rheumatology,
University of Alabama School of Medicine, Birmingham, Alabama
Ronald J. Anderson MD
Associate Professor
Department of Medicine, Division of Rheumatology, Immunology, and Allergy,
Harvard Medical School, Brigham and Women’s Hospital, Boston,
Massachusetts
Evangelos T. H. Andreakos BSc, DIC, PhD
Senior Research Fellow
Kennedy Institute of Rheumatology Division, Imperial College London Faculty of
Medicine, London, United Kingdom
William P. Arend MD
Scoville Professor of Rheumatology
Department of Medicine, University of Colorado School of Medicine, Denver,
Colorado
John Patterson Atkinson MD
Samuel B. Grant Professor of Medicine; Professor of Molecular Biology
Department of Medicine, Division of Rheumatology, Washington University
School of Medicine, St. Louis, Missouri
Catherine L. Backman PhD, OT(C)
Associate Professor
School of Rehabilitation Sciences, University of British Columbia Faculty of
Medicine; Research Scientist, Arthritis Research Centre of Canada, Vancouver,
British Columbia, Canada
Philip E. Blazar MD
Assistant Professor of Orthopaedic Surgery
Department of Orthopaedics, Harvard Medical School, Brigham and Women’s
Hospital, Boston, Massachusetts
Ferdinand C. Breedveld MD
Professor
Department of Rheumatology, Leiden University Medical Center, Leiden, The
Netherlands
Fionula M. Brennan BSc, PhD
Professor of Cytokine Immunopathology
Kennedy Institute of Rheumatology Division, Imperial College London Faculty of
Medicine, London, United Kingdom
S. Louis Bridges Jr. MD, PhD
Associate Professor
Departments of Medicine and Microbiology, University of Alabama School of
Medicine, Birmingham, Alabama
Nathalie D. Burg MD
Postdoctoral Fellow
Laboratory of Blood and Vascular Biology, The Rockefeller University, New York,
New York
Lisa C. Campbell PhD
Department of Psychiatry and Behavioral Sciences, Duke University Medical
Center, Durham, North Carolina
Grant W. Cannon MD
Professor of Medicine
Division of Rheumatology, University of Utah School of Medicine; Associate Chief
of Staff for Academic Affiliations, VA Salt Lake City Health Care System, Salt
Lake City, Utah
Wayne K. Cheng MD
Instructor
Department of Orthopaedics, Loma Linda University Medical Center, Loma Linda,
California
Philip G. Conaghan MB, MS, FRACP
Senior Lecturer
Department of Musculoskeletal Disease, University of Leeds School of Medicine,
Honorary Consultant, Leeds General Infirmary, Leeds, United Kingdom
R. Lee Cothran Jr. MD
Clinical Associate
Department of Radiology, Duke University School of Medicine, Duke University
Medical Center, Durham, North Carolina
Leslie J. Crofford MD
Associate Professor
Department of Internal Medicine, University of Michigan Medical School, Ann
Arbor, Michigan
Anne Davidson MBBS
Professor
Departments of Medicine and Microbiology and Immunology, Albert Einstein
College of Medicine of Yeshiva University, Bronx, New York
Paola de Pablo MD, MPH
Postdoctoral Fellow
Department of Rheumatology, Immunology, and Allergy, Harvard Medical School,
Brigham and Women's Hospital, Boston, Massachusetts
Mark E. Easley MD
Assistant Professor of Surgery
Department of Orthopaedic Surgery, Duke University Medical Center, Durham,
North Carolina
Paul Emery MA, MD, FRCP
ARC Professor of Rheumatology; Head of Academic Unit of Musculoskeletal
Disease
Department of Musculoskeletal Disease, University of Leeds Medical School;
Clinical Director, Leeds Teaching Hospitals Trust, Leeds, United Kingdom
Angela Fairleigh OT (Reg) BC
Department of Occupational Therapy, Mary Pack Arthritis Centre, Vancouver
General Hospital, Vancouver, British Columbia, Canada
Marc Feldmann MBBS, BSc, PhD, FRCP, FRCPath
Professor of Immunology
Kennedy Institute of Rheumatology Division, Imperial College London Faculty of
Medicine, London, United Kingdom
Beverley F. Fermor PhD
Assistant Professor
Department of Surgery, Duke University Medical Center, Durham, North Carolina
Brian M. J. Foxwell BSc, PhD
Professor of Immune Cell Signaling
Department of Cytokine Biology and Cellular Immunology, Imperial College
London Faculty of Medicine, London, United Kingdom
Daniel E. Furst AB, MD
Carl M. Pearson Professor of Rheumatology
Department of Rheumatology, University of California, Los Angeles, David Geffen
School of Medicine at UCLA, Los Angeles, California
Cem Gabay MD
Associate Professor of Medicine
Departments of Internal Medicine and Pathology/Immunology, Division of
Rheumatology, University Hospital of Geneva, Geneva, Switzerland
Sherine E. Gabriel MD, MSc
Professor of Medicine (Rheumatology) and Epidemiology
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
Renate E. Gay MD
Professor of Experimental Rheumatology
Department of Rheumatology, University of Zurich, University Hospital, Zurich,
Switzerland
Steffen Gay MD
Professor of Experimental Rheumatology
Department of Rheumatology, University of Zurich, University Hospital, Zurich,
Switzerland
Mary B. Goldring PhD
Division of Rheumatology, Beth Israel Deaconess Medical Center, New England
Baptist Bone & Joint Institute, Boston, Massachusetts
Steven R. Goldring MD
Division of Rheumatology, Beth Israel Deaconess Medical Center, New England
Baptist Bone & Joint Institute, Boston, Massachusetts
J ¶rg J. Goronzy MD, PhD
Professor of Medicine
Lowance Center for Human Immunology, Emory University School of Medicine,
Atlanta, Georgia
Peter K. Gregersen MD
Professor of Medicine and Pathology
Robert S. Boas Center for Genomics and Human Genetics, New York University
School of Medicine, New York, New York, North Shore LIJ Research Institute,
Manhasset, New York
Farshid Guilak PhD
Associate Professor
Department of Surgery, Duke University Medical Center, Durham, North Carolina
Boulos Haraoui MD, FRCPC
Clinical Associate Professor of Medicine
Department of Medicine, Universit © de Montr ©al, Faculty of Medicine,
CHUM, H ´pital Notre-Dome, Montr ©al, Quebec, Canada
Barton F. Haynes MD
Frederic M. Hanes Professor of Medicine; Professor of Immunology
Description:This authoritative clinical reference provides comprehensive coverage of all aspects of rheumatoid arthritis. The basics of rheumatoid arthritis are thoroughly covered in order to provide a firm foundation for the main focus of the text: therapy and clinical management of the disease. Practitioners
