"Diagnosis is based on a combination of clinical, radiographic, and serological criteria. The 2010 ACR-EULAR classification criteria for Rheumatoid Arthritis 4 has a maximal score of 10 and requires a score of >6 for a diagnosis of rheumatoid arthritis to be made:"
"0: negative RF and negative anti-CCP"
"2: low-positive RF or low-positive anti-CCP"
"3: high-positive RF or high-positive anti-CCP"
"0: normal CRP and normal ESR"
"1: abnormal CRP and abnormal ESR"
"rheumatoid nodules: usually seen in pressure areas (e.g. elbows, occiput, lumbosacral) 3 in RF-positive patients 9"
"activation of the macrophages and synovial cells and production of cytokines such as IL4 and TNF, which in turn cause proliferation of the synovial cells and increase the production of destructive enzymes such as elastase and collagenase by macrophages"
"activating B cell lymphocytes to produce various antibodies, including rheumatoid factor (RF-IgM antibodies against the Fc portion of the IgG), which makes immune complexes that deposit in different tissues and contribute to further injury"
"producing RANKL, which in turn activate osteoclasts, causing subchondral bone destruction"
"elevated CRP and/or ESR"
"biological DMARDs (bDMARDs): e.g. TNF-α inhibitors (e.g. infliximab), tocilizumab, abatacept, rituxumab"
"IgM antibody against the Fc portion of the IgG antibodies"
"There are several serological markers for rheumatoid arthritis ref:"
"The disease carries a significant burden of disability. There is also a reduction in life expectancy, with excess mortality usually related to its non-articular manifestations 5,6."