Join(t) us in learning about rheumatoid arthritis care for the internist with Robert McLean MD, rheumatologist, Associate Clinical Professor at Yale, and President Elect of the ACP! We discuss the complexity of rheumatoid arthritis, how to differentiate from other arthritic conditions, and how to have a patient-centered framework for the evaluation and treatment of affected patients. ACP members can claim CME-MOC credit at on ACP's site.. Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Writer (Interview & CME questions): Cyrus Askin MD Show Notes and Infographic by: Elena Gibson MS4 Hosts: Matthew Watto MD, Stuart Brigham MD Editors: Matthew Watto MD, Emi Okamoto MD Guest: Robert McLean MD Time Stamps 00:35 Disclaimer, intro and guest bio 03:38 Guest onliner; Nudge (book) on behavioral economics 08:30 Favorite failure; Stuart’s pick of the week 12:24 Key historical features of RA 15:30 Differential diagnosis 19:20 Physical findings in RA 20:58 Initial labs orders for suspected inflammatory arthritis; CRP vs high sensitivity (cardio) CRP assays 27:45 Epidemiology of RA; Is there a utility for scoring systems?; A bit more on inflammatory markers 32:30 Recap and test interpretation 36:22 High yield physical exam in RA 40:56 Initial counseling after RA diagnosis 46:00 Therapeutic trial with NSAIDS or steroids for inflammatory arthritis 50:29 When to reach for the DMARDS 52:40 Are steroids considered DMARDS? 54:50 Primary care considerations for patients starting steroids or DMARDS (TB, vaccinations) 60:34 When and how long to hold DMARDS for surgery or acute illness 62:10 Drug-drug interactions and monitoring with methotrexate, hydroxychloroquine, sulfasalazine 70:10 Anti-inflammatory diets 73:30 Take home points 76:00 Outro