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lüll Managing early presentation of rheumatoid arthritis Systematic overview Glazier RCan Fam Physician 1996[May]; 42 (ä): 913-22OBJECTIVE: To describe evidence-based management of patients presenting to family physicians with typical signs and symptoms of recent onset of rheumatoid arthritis (RA). STUDY SELECTION: Articles for critical review were included if relevant to primary care management of early RA (less than 1 year duration). Sources included MEDLINE from 1966 to December 1995, the reference library of the Arthritis Community Research and Evaluation Unit, and conference abstracts. FINDINGS: Evidence from randomized, controlled trials supports the short-term benefit of nonsteroidal anti-inflammatory drugs, disease-modifying agents for rheumatic diseases, intravenous pulse corticosteroid therapy, intra-articular therapy, aerobic exercise, patient education, psychologic intervention, home physiotherapy, home occupational therapy, and rehabilitation programs. Some evidence favours acetaminophen for analgesia, low-dose oral corticosteroids for symptom control, and referral to a rheumatologist. Evidence for rest, ice, and heat for symptom control is conflicting and based on low-quality studies. CONCLUSION: Family physicians play an important role in establishing early and accurate diagnosis of RA, coordinating therapy, and providing ongoing support, education, and monitoring to patients and their families.|*Physician's Role[MESH]|Arthritis, Rheumatoid/classification/*diagnosis/*therapy[MESH]|Continuity of Patient Care[MESH]|Family Practice/*methods[MESH]|Humans[MESH]|Patient Education as Topic[MESH]|Randomized Controlled Trials as Topic[MESH]|Referral and Consultation[MESH]|Treatment Outcome[MESH] |