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Analise Schaefer, a 54-year-old African American woman with a 13-year history of rheumatoid arthritis and heart failure, presents with worsening joint pain, stiffness, fatigue, and decreased range of motion. Examination finds 16 tender and swollen joints bilaterally. X-rays show erosions and joint space narrowing. Laboratory tests include an elevated ESR and positive RF and anti-CCP. Her DAS28 score increased from 3.0 to 6.2, indicating high disease activity. She requires optimization of her rheumatoid arth

Author

ندى القلوي

Language

EN