by Victoria Ruffing, R.N., C.C.R.P. and Clifton O. Bingham III, M.D.EpidemiologyClinical HistoryPhysical ExaminationExtra-Articular DiseaseLaboratory TestsRadiographic FindingsClinical CourseEpidemiologyRheumatoid arthritis has a worldwide distribution with an estimated prevalence of 1 to 2%. Prevalence increases with age, approaching 5% in women over age 55. The average annual incidence in the United States is about 70 per 100,000 annually. Both incidence and prevalence of rheumatoid arthritis are two to three times greater in women than in men. Although rheumatoid arthritis may present at any age, patients most commonly are first affected in the third to sixth decades.Clinical HistoryThe typical case of rheumatoid arthritis begins insidiously, with the slow development of signs and symptoms over weeks to months. Often the patient first notices stiffness in one or more joints, usually accompanied by pain on movement and by tenderness in the joint. The number of joints involved is high...
