Frühdiagnostik der rheumatoiden Arthritis

Zusammenfassung

Die rheumatoide Arthritis (RA) führt unbehandelt über chronische Entzündungsprozesse der Synovialis zur Zerstörung von Gelenken und hat damit eine erhebliche Morbidität der Patienten zur Folge. Ein früher Therapiebeginn innerhalb von drei Monaten (sogenanntes „Window of Opportunity“) mit dem Ziel einer konsequenten Krankheitskontrolle verbessert die Langzeitprognose der Patienten erheblich. Voraussetzung für das Errei-chen dieses Ziels ist eine frühe Diagnose -sicherung. Die ACR/EULAR-Klassifikationskriterien 2010 sind dabei ein wichtiges Instrument. Ihr sinnvoller Einsatz in der klinischen Routine in Kombination mit rationeller Labor-diagnostik, modernen bildgebenden Verfahren und nicht zuletzt guter Kooperation mit primärversorgenden Hausärzten und Inter-nisten im Rahmen von Überweisungsstrategien ermöglichen es, das Ziel der nationalen Leitlinien einer Diagnose und eines Therapiebeginns innerhalb von drei bis sechs Monaten zu erfüllen. Dies setzt eine informierte Bevölkerung, gut geschulte Primärärzte und einen guten Zugang zur spezialärztlichen rheumatologischen Versorgung voraus.

Summary

Rheumatoid arthritis (RA) is characterized by a chronic synovial inflammation which causes irreversible destruction of joints and results in considerable morbidity of patients if left untreated. Early initiation of treatment within three months (so called “Window of Opportunity”) in combination with strict disease control substantially ameliorates the prognosis. Early diagnosis therefore becomes of utmost importance. The 2010 ACR/EULAR classification criteria were geared to permit an early diagnosis of RA. Their judicious application in clinical routine combined with rational laboratory diagnostics, modern imaging techniques, and early referral strategies permits to achieve the targets of national guidelines that stipulate diagnosis and initiation of RA treatment within three to six months. A prerequisite for this strategy consists in an informed population, well trained general practitioners and an adequate connection to specialized rheumato-logic care.

Schlüsselwörter

Rheumatoide Arthritis - Frühdiagnostik - Klassifikationskriterien - Bildgebung

Keywords

Rheumatoid arthritis - early diagnosis - classification criteria - imaging

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