Rheumatology Disease Classification
Inflammatroy Arthritis
Rheumatoid ...

Rheumatology Disease Classification

Inflammatroy Arthritis

Rheumatoid arthritis

 • F > M, Age 35-65, RF+/CCP+ (70%-80%)

 • Symmetric chronic inflammatory polyarthritis

Psoriatic arthritis 

 • M = F, Age 30-55, RF+ (2%-10%)

 • Asymmetric, large joints; 50% w/ RA distrib; majority w/ history of psoriasis, examine nails

Reactive arthritis (post-infx)

 • M > F Age 16-50, RF-, HLA-B27+ (50%-80%) 

 • a/w enthesitis, LBP, ocular sx, GU/GI sx

Enteropathic arthritis

 • M = F, All ages, RF- 

 • a/w enthesitis, oral ulcers; 20% w/IBD

Axial spondyloarthritis (e.g., ankylosing spondylitis)

 • M > F, Age 15-45, HLA-B27+ (>50%)

 • Asymmetric, large joints; LE>UE, enthesitis, dactylitis; a/w “silent” GU infxn (e.g., GC/Chla)


 • M > F, Age >25, RF-

 • Intermittent inflammatory; usu. monoarticular


 • F = M, Age >60, RF-

 • 5% w/ RA-like arthritis lasting for wks to months

Viral arthritis

 • F > M, All ages, RF+ (<10%); consider Parvovirus B19 Ab, 

 • Acute symmetric polyarthritis w/ RA distribution; <10% develop chronic polyarthritis

Connective Tissue Disease

Systemic lupus erythematosus (SLE) 

 • F > M, Age 15-40, ANA+ (>95%), antidsDNA (70%), antiSm/ RNP (30%), antihistone, C3/4

 • Sx: rash, oral ulcers, arthritis, serositis, renal dz, neuro d/o, heme abnormalities. ↑ CK suggests myositis

Sjögren’s syndrome (SS)

 • F > M, Age 40-60, Anti-Ro(SSA)/La(SSB), [often ANA≥1:320 and RF+], lip bx

 • Sx: sicca sx, parotid gland inflam., dental caries; RA/SLE a/w 2° SS; if dx uncertain, perform lip bx; if salivary gland enlarged, consider IgG4

Systemic sclerosis (SSc) (a.k.a., scleroderma)

 • F:M 4:1, Age 30-50, ANA+ (95%), anti-Scl70*, ACA*, anti-RNApol 3* *any are >99% specific

 • Types: Local (linear/morphea) vs. systemic (dcSSc, lcSSc, SSc sine scleroderma)

 • Sx: CREST; scleroderma renal crisis; ILD

Mixed connective tissue dz 

 • 80% F, Age 20-30, ANA (speckled), antiU1RNP (100%)

 • Sx: clin. ft. of SLE, SSc, myositis overlapping over many yrs.; pHTN


 • F:M 2:1, Age 40-50, ANA+ (up to 80%), cytoplasmic (e.g., antiJo1)

 • Sx: Proximal muscle weakness, rashes, GERD/dysphagia; may cause antisynthetase

syndrome (ILD, myopathy, arthritis) 


 • Large-vessel vasculitis: Takayasu arteritis; giant cell arteritis (GCA)

 • Medium-vessel vasculitis: Polyarteritis nodosa; Kawasaki disease (usually in children, can affect large vessels)

 • Small-vessel vasculitis: 

    - ANCA-associated: (Granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis, microscopic polyangiitis)

    - Immune complex-associated: (Cryoglobulinemic, IgA [Henoch-Schönlein purpura], hypocomplementemic urticarial (anti-C1q)

#Rheumatology #Disease #Classification #diagnosis
Contributed by

MGH White Book Manual
Account created for the MGH Internal Medicine Housestaff Manual "White Book" - https://stk10.github.io/MGH-Docs/WhiteBook-2019-2020.pdf

Related content