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INTRODUCTION

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Rheumatoid arthritis and osteoarthritis represent the two primary pathological conditions that affect the joints and periarticular structures. Although the causes underlying these conditions are quite different from one another, both conditions can cause severe pain and deformity in various joints in the body. Pharmacological management plays an important role in the treatment of each disorder. Because physical therapists and other rehabilitation specialists often work with patients who have rheumatoid arthritis or osteoarthritis, an understanding of the types of drugs used to treat these diseases is important.

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This chapter begins by describing the etiology of rheumatoid joint disease and the pharmacological treatment of rheumatoid arthritis. An analogous discussion of osteoarthritis follows. These descriptions should clarify drug therapy's role in arthritis and the impact drugs can have on patients receiving physical therapy and occupational therapy.

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RHEUMATOID ARTHRITIS

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Rheumatoid arthritis (RA) is a chronic, systemic disorder that affects many different tissues in the body but is primarily characterized by synovitis and the destruction of articular tissue.13 This disease is associated with pain, stiffness, and inflammation in the small synovial joints of the hands and feet and in larger joints such as the knee. Although marked by periods of exacerbation and remission, RA is often progressive in nature, with advanced stages leading to severe joint destruction and bone erosion. Specific criteria for the diagnosis of RA in adults are listed in Table 16-1.

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Table 16-1THE 2010 ACR-EULAR* CLASSIFICATION CRITERIA FOR RHEUMATOID ARTHRITIS

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