How is enlargement of the synovial membrane noted on physical exam in rheumatoid arthritis (RA)?

1. [Guideline] Aletaha D, Neogi T, Silman AJ, et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2010 Sep. 62(9):2569-81. [Medline]. [Full Text].

2. [Guideline] Anderson J, Caplan L, Yazdany J, et al, for the American College of Rheumatology. Rheumatoid arthritis disease activity measures: American College of Rheumatology Recommendations for use in clinical practice. Arthritis Care Res (Hoboken). 2012. 64:640-7. [Medline]. [Full Text].

3. [Guideline] Felson DT, Smolen JS, Wells G, Zhang B, van Tuyl LH, et al. American College of Rheumatology/European League Against Rheumatism provisional definition of remission in rheumatoid arthritis for clinical trials. Arthritis Rheum. 2011 Mar. 63 (3):573-86. [Medline]. [Full Text].

4. [Guideline] Singh JA, Saag KG, et al. 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. http://dx.doi.org/10.1002/art.39480 (2015). Arthritis Care and Research. 2015. [Medline]. [Full Text].

5. [Guideline] Smolen JS, Landewé RBM, Bijlsma JWJ, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis. 2020 Jan 22. 73(3):492-509. [Medline]. [Full Text].

6. Donahue KE, Jonas DE, Hansen RA, Roubey R, Jonas B, Lux LJ, et al. Agency for Healthcare Research and Quality. Choosing Medications for Rheumatoid Arthritis. 2012 Apr. [Medline]. [Full Text].

7. Kelly JC. Rheumatoid arthritis: Updated recommendations released. Medscape Medical News. Available at http://www.medscape.com/viewarticle/845495. May 28, 2015; Accessed: June 30, 2015.

8. [Guideline] Smolen JS, Breedveld FC, Burmester GR, Bykerk V, Dougados M, et al. Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international task force. Ann Rheum Dis. 2015 May 12. [Medline]. [Full Text].

9. Carlens C, Hergens MP, Grunewald J, et al. Smoking, use of moist snuff, and risk of chronic inflammatory diseases. Am J Respir Crit Care Med. 2010 Jun 1. 181(11):1217-22. [Medline].

10. Barton A, Worthington J. Genetic susceptibility to rheumatoid arthritis: an emerging picture. Arthritis Rheum. 2009 Oct 15. 61(10):1441-6. [Medline].

11. Begovich AB, Carlton VE, Honigberg LA, et al. A missense single-nucleotide polymorphism in a gene encoding a protein tyrosine phosphatase (PTPN22) is associated with rheumatoid arthritis. Am J Hum Genet. 2004 Aug. 75(2):330-7. [Medline].

12. Potter C, Eyre S, Cope A, Worthington J, Barton A. Investigation of association between the TRAF family genes and RA susceptibility. Ann Rheum Dis. 2007 Oct. 66(10):1322-6. [Medline].

13. Prakken B, Albani S, Martini A. Juvenile idiopathic arthritis. Lancet. 2011 Jun. 377(9783):2138-49. [Medline].

14. Hinks A, Ke X, Barton A, Eyre S, Bowes J, Worthington J. Association of the IL2RA/CD25 gene with juvenile idiopathic arthritis. Arthritis Rheum. 2009 Jan. 60(1):251-7. [Medline].

15. Ahlmen M, Svensson B, Albertsson K, Forslind K, Hafstrom I. Influence of gender on assessments of disease activity and function in early rheumatoid arthritis in relation to radiographic joint damage. Ann Rheum Dis. 2010 Jan. 69(1):230-3. [Medline].

16. Areskoug-Josefsson K, Oberg U. A literature review of the sexual health of women with rheumatoid arthritis. Musculoskeletal Care. 2009 Dec. 7(4):219-26. [Medline].

17. Martin-Trujillo A, van Rietschoten JG, Timmer TC, et al. Loss of imprinting of IGF2 characterises high IGF2 mRNA-expressing type of fibroblast-like synoviocytes in rheumatoid arthritis. Ann Rheum Dis. 2010 Jun. 69(6):1239-42. [Medline].

18. Zhou X, Chen W, Swartz MD, et al. Joint linkage and imprinting analyses of GAW15 rheumatoid arthritis and gene expression data. BMC Proc. 2007. 1 Suppl 1:S53. [Medline].

19. Barlow DP. Genomic imprinting: a mammalian epigenetic discovery model. Annu Rev Genet. 2011. 45:379-403. [Medline].

20. Hitchon CA, Chandad F, Ferucci ED, et al. Antibodies to porphyromonas gingivalis are associated with anticitrullinated protein antibodies in patients with rheumatoid arthritis and their relatives. J Rheumatol. 2010 Jun. 37(6):1105-12. [Medline].

21. Routsias JG, Goules JD, Goules A, Charalampakis G, Pikazis D. Autopathogenic correlation of periodontitis and rheumatoid arthritis. Rheumatology (Oxford). 2011 Jul. 50(7):1189-93. [Medline].

22. Barrett JH, Brennan P, Fiddler M, Silman AJ. Does rheumatoid arthritis remit during pregnancy and relapse postpartum? Results from a nationwide study in the United Kingdom performed prospectively from late pregnancy. Arthritis Rheum. 1999 Jun. 42(6):1219-27. [Medline].

23. Jorgensen KT, Pedersen BV, Jacobsen S, Biggar RJ, Frisch M. National cohort study of reproductive risk factors for rheumatoid arthritis in Denmark: a role for hyperemesis, gestational hypertension and pre-eclampsia?. Ann Rheum Dis. 2010 Feb. 69(2):358-63. [Medline].

24. Guthrie KA, Dugowson CE, Voigt LF, Koepsell TD, Nelson JL. Does pregnancy provide vaccine-like protection against rheumatoid arthritis?. Arthritis Rheum. 2010 Jul. 62(7):1842-8. [Medline]. [Full Text].

25. Shah A, St. Clair EW. Rheumatoid Arthritis. In: Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J, Eds. Harrison's Principles of Internal Medicine. 19th ed. New York, NY: McGraw-Hill Education; 2016.

26. Gremese E, Salaffi F, Bosello SL, et al. Very early rheumatoid arthritis as a predictor of remission: a multicentre real life prospective study. Ann Rheum Dis. 2013 Jun. 72(6):858-62. [Medline].

27. Weinblatt ME, Keystone EC, Cohen MD, et al. Factors associated with radiographic progression in patients with rheumatoid arthritis who were treated with methotrexate. J Rheumatol. 2011 Feb. 38(2):242-6. [Medline].

28. Agrawal S, Misra R, Aggarwal A. Autoantibodies in rheumatoid arthritis: association with severity of disease in established RA. Clin Rheumatol. 2007 Feb. 26(2):201-4. [Medline].

29. Vencovsky J, Machacek S, Sedova L, et al. Autoantibodies can be prognostic markers of an erosive disease in early rheumatoid arthritis. Ann Rheum Dis. 2003 May. 62(5):427-30. [Medline].

30. Sokka T, Kautiainen H, Mottonen T, Hannonen P. Work disability in rheumatoid arthritis 10 years after the diagnosis. J Rheumatol. 1999 Aug. 26(8):1681-5. [Medline].

31. Mollard E, Pedro S, Chakravarty E, Clowse M, Schumacher R, Michaud K. The impact of menopause on functional status in women with rheumatoid arthritis. Rheumatology. 29 January 2018. [Full Text].

32. Lindhardsen J, Ahlehoff O, Gislason GH, et al. Risk of atrial fibrillation and stroke in rheumatoid arthritis: Danish nationwide cohort study. BMJ. 2012. 344:e1257. [Medline].

33. Hawley DJ. Psycho-educational interventions in the treatment of arthritis. Baillieres Clin Rheumatol. 1995 Nov. 9(4):803-23. [Medline].

34. Tucker M, Kirwan JR. Does patient education in rheumatoid arthritis have therapeutic potential?. Ann Rheum Dis. 1991 Jun. 50 suppl 3:422-8. [Medline]. [Full Text].

35. Thompson A. Practical aspects of therapeutic intervention in rheumatoid arthritis. J Rheumatol Suppl. 2009 Jun. 82:39-41. [Medline].

36. Komano Y, Harigai M, Koike R, Sugiyama H, Ogawa J, Saito K. Pneumocystis jiroveci pneumonia in patients with rheumatoid arthritis treated with infliximab: a retrospective review and case-control study of 21 patients. Arthritis Rheum. 2009 Mar 15. 61(3):305-12. [Medline].

37. Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO 3rd. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis. 2010 Sep. 69(9):1580-8. [Medline].

38. Radner H, Neogi T, Smolen JS, Aletaha D. Performance of the 2010 ACR/EULAR classification criteria for rheumatoid arthritis: a systematic literature review. Ann Rheum Dis. 2014 Jan. 73 (1):114-23. [Medline].

39. Katchamart W, Johnson S, Lin HJ, Phumethum V, Salliot C, Bombardier C. Predictors for remission in rheumatoid arthritis patients: A systematic review. Arthritis Care Res (Hoboken). 2010 Aug. 62(8):1128-43. [Medline].

40. Varache S, Narbonne V, Jousse-Joulin S, et al. Is routine viral screening useful in patients with recent-onset polyarthritis of a duration of at least 6 weeks? Results from a nationwide longitudinal prospective cohort study. Arthritis Care Res (Hoboken). 2011 Nov. 63(11):1565-70. [Medline].

41. Aletaha D, Alasti F, Smolen JS. Rheumatoid factor determines structural progression of rheumatoid arthritis dependent and independent of disease activity. Ann Rheum Dis. Jul 13 2012. [Medline].

42. Scott IC, Steer S, Lewis CM, Cope AP. Precipitating and perpetuating factors of rheumatoid arthritis immunopathology: linking the triad of genetic predisposition, environmental risk factors and autoimmunity to disease pathogenesis. Best Pract Res Clin Rheumatol. 2011 Aug. 25(4):447-68. [Medline].

43. Daha NA, Toes RE. Rheumatoid arthritis: Are ACPA-positive and ACPA-negative RA the same disease?. Nat Rev Rheumatol. 2011 Apr. 7(4):202-3. [Medline].

44. van Venrooij WJ, van Beers JJ, Pruijn GJ. Anti-CCP antibodies: the past, the present and the future. Nat Rev Rheumatol. 2011 Jun 7. 7(7):391-8. [Medline].

45. Mjaavatten MD, van der Heijde DM, Uhlig T, et al. Should Anti-citrullinated Protein Antibody and Rheumatoid Factor Status Be Reassessed During the First Year of Followup in Recent-Onset Arthritis? A Longitudinal Study. J Rheumatol. 2011 Nov. 38(11):2336-41. [Medline].

46. Bang H, Egerer K, Gauliard A, et al. Mutation and citrullination modifies vimentin to a novel autoantigen for rheumatoid arthritis. Arthritis Rheum. 2007. 56(8):2503–11. [Medline].

47. Coenen D, Verschueren P, Westhovens R, Bossuyt X. Technical and diagnostic performance of 6 assays for the measurement of citrullinated protein/peptide antibodies in the diagnosis of rheumatoid arthritis. Clin Chem. 2007. 53(3):498–504. [Medline].

48. Soos L, Szekanecz Z, Szabo Z, et al. Clinical evaluation of anti-mutated citrullinated vimentin by ELISA in rheumatoid arthritis. J Rheumatol. 2007. 34(8):1658–63. [Medline].

49. Szekanecz Z, Soos L, Szabo Z, et al. Anti-citrullinated protein antibodies in rheumatoid arthritis: as good as it gets?. Clin Rev Allergy Immunol. 2008. 34(1):26–31. [Medline].

50. Goodman A. Novel biomarkers improve diagnosis in early RA. Medscape Medical News. June 20, 2013. [Full Text].

51. De Winter L, Hansen W, Geusens P, et al. New autoantibodies as biomarkers for early and seronegative rheumatoid arthritis [abstract OP0181]. Presented at: EULAR 2013, the Annual Congress of the European League Against Rheumatism; Madrid, Spain; June 14, 2013. Ann Rheum Dis. 2013. 72(suppl 3):114. [Full Text].

52. van der Heijde DM. Radiographic imaging: the ‘gold standard’ for assessment of disease progression in rheumatoid arthritis. Rheumatology (Oxford). 2000 Jun. 39 suppl 1:9-16. [Medline].

53. Tan YK, Conaghan PG. Imaging in rheumatoid arthritis. Best Pract Res Clin Rheumatol. 2011 Aug. 25(4):569-84. [Medline].

54. Wells AF, Haddad RH. Emerging role of ultrasonography in rheumatoid arthritis: optimizing diagnosis, measuring disease activity and identifying prognostic factors. Ultrasound Med Biol. 2011 Aug. 37(8):1173-84. [Medline].

55. Bruno MA, Wakefield RJ. Chapter 5: Ultrasound of Rheumatoid Arthritis. Bruno MA, Mosher TJ, Gold GE. Arthritis in Color: Advanced Imaging of Arthritis. Philadelphia, PA: Saunders-Elsevier; 2009. 96-122.

56. Cheung PP, Dougados M, Gossec L. Reliability of ultrasonography to detect synovitis in rheumatoid arthritis: a systematic literature review of 35 studies (1,415 patients). Arthritis Care Res (Hoboken). 2010 Mar. 62(3):323-34. [Medline].

57. Fiocco U, Ferro F, Vezzu M, et al. Rheumatoid and psoriatic knee synovitis: clinical, grey scale, and power Doppler ultrasound assessment of the response to etanercept. Ann Rheum Dis. 2005 Jun. 64(6):899-905. [Medline]. [Full Text].

58. Suter LG, Fraenkel L, Braithwaite RS. Role of magnetic resonance imaging in the diagnosis and prognosis of rheumatoid arthritis. Arthritis Care Res (Hoboken). 2011 May. 63(5):675-88. [Medline].

59. Cyteval C. Doppler ultrasonography and dynamic magnetic resonance imaging for assessment of synovitis in the hand and wrist of patients with rheumatoid arthritis. Semin Musculoskelet Radiol. 2009 Mar. 13(1):66-73. [Medline].

60. Fukae J, Kon Y, Henmi M, Sakamoto F, Narita A, Shimizu M. Change of synovial vascularity in a single finger joint assessed by power doppler sonography correlated with radiographic change in rheumatoid arthritis: comparative study of a novel quantitative score with a semiquantitative score. Arthritis Care Res (Hoboken). 2010 May. 62(5):657-63. [Medline].

61. Zayat AS, Conaghan PG, Sharif M, et al. Do non-steroidal anti-inflammatory drugs have a significant effect on detection and grading of ultrasound-detected synovitis in patients with rheumatoid arthritis? Results from a randomised study. Ann Rheum Dis. 2011 Oct. 70(10):1746-51. [Medline].

62. Kelleher MO, McEvoy L, Yang JP, Kamel MH, Bolger C. Lateral mass screw fixation of complex spine cases: a prospective clinical study. Br J Neurosurg. 2008 Oct. 22(5):663-8. [Medline].

63. Cakir B, Kafer W, Reichel H, Schmidt R. [Surgery of the cervical spine in rheumatoid arthritis. Diagnostics and indication]. Orthopade. 2008 Nov. 37(11):1127-40; quiz 1141. [Medline].

64. Narvaez JA, Narvaez J, Serrallonga M, et al. Cervical spine involvement in rheumatoid arthritis: correlation between neurological manifestations and magnetic resonance imaging findings. Rheumatology (Oxford). 2008 Dec. 47(12):1814-9. [Medline].

65. Verstappen SM, Albada-Kuipers GA, Bijlsma JW, et al, for the Utrecht Rheumatoid Arthritis Cohort Study Group (SRU). A good response to early DMARD treatment of patients with rheumatoid arthritis in the first year predicts remission during follow up. Ann Rheum Dis. 2005. 64:38-43. [Medline].

66. Aletaha D, Funovits J, Keystone EC, Smolen JS. Disease activity early in the course of treatment predicts response to therapy after one year in rheumatoid arthritis patients. Arthritis Rheum. 2007. 56:3226-35. [Medline].

67. Verschueren P, Esselens G, Westhovens R. Predictors of remission, normalized physical function, and changes in the working situation during follow-up of patients with early rheumatoid arthritis: an observational study. Scand J Rheumatol. 2009. 38:166-72. [Medline].

68. [Guideline] Singh JA, Furst DE, Bharat A, Curtis JR, Kavanaugh AF, et al. 2012 update of the 2008 American College of Rheumatology recommendations for the use of disease-modifying antirheumatic drugs and biologic agents in the treatment of rheumatoid arthritis. Arthritis Care Res (Hoboken). 2012 May. 64 (5):625-39. [Medline]. [Full Text].

69. Callhoff J, Weiss A, Zink A, Listing J. Impact of biologic therapy on functional status in patients with rheumatoid arthritis--a meta-analysis. Rheumatology (Oxford). 2013 Dec. 52(12):2127-35. [Medline].

70. Bili A, Sartorius JA, Kirchner HL, et al. Hydroxychloroquine use and decreased risk of diabetes in rheumatoid arthritis patients. J Clin Rheumatol. 2011 Apr. 17(3):115-20. [Medline].

71. Solomon DH, Massarotti E, Garg R, et al. Association between disease-modifying antirheumatic drugs and diabetes risk in patients with rheumatoid arthritis and psoriasis. JAMA. 2011 Jun 22. 305(24):2525-31. [Medline].

72. Brooks M. FDA OKs Methotrexate Autoinjector (Otrexup). Medscape Medical News. Oct 18 2013. [Full Text].

73. Glen S Hazlewood, Cheryl Barnabe, George Tomlinson, Deborah Marshall, Dan Devoe, Claire Bombardier. Methotrexate monotherapy and methotrexate combination therapy with traditional and biologic disease modifying antirheumatic drugs for rheumatoid arthritis: abridged Cochrane systematic review and network meta-analysis. BMJ. 2016. 353:[Medline].

74. Furst DE, Breedveld FC, Kalden JR, et al. Updated consensus statement on biological agents for the treatment of rheumatic diseases, 2007. Ann Rheum Dis. 2007 Nov. 66 Suppl 3:iii2-22. [Medline].

75. Garces S, Demengeot J, Benito-Garcia E. The immunogenicity of anti-TNF therapy in immune-mediated inflammatory diseases: a systematic review of the literature with a meta-analysis. Ann Rheum Dis. 2013 Dec. 72(12):1947-55. [Medline].

76. Galloway JB, Hyrich KL, Mercer LK, et al. Risk of septic arthritis in patients with rheumatoid arthritis and the effect of anti-TNF therapy: results from the British Society for Rheumatology Biologics Register. Ann Rheum Dis. 2011 Oct. 70(10):1810-1814. [Medline]. [Full Text].

77. Lan JL, Chen YM, Hsieh TY, et al. Kinetics of viral loads and risk of hepatitis B virus reactivation in hepatitis B core antibody-positive rheumatoid arthritis patients undergoing anti-tumour necrosis factor alpha therapy. Ann Rheum Dis. 2011 Oct. 70(10):1719-25. [Medline].

78. Askling J, van Vollenhoven RF, Granath F, et al. Cancer risk in patients with rheumatoid arthritis treated with anti-tumor necrosis factor alpha therapies: does the risk change with the time since start of treatment?. Arthritis Rheum. 2009 Nov. 60(11):3180-9. [Medline].

79. Finzel S, Rech J, Schmidt S, et al. Repair of bone erosions in rheumatoid arthritis treated with tumour necrosis factor inhibitors is based on bone apposition at the base of the erosion. Ann Rheum Dis. 2011 Sep. 70(9):1587-93. [Medline].

80. van Vollenhoven RF, Ernestam S, Geborek P, Petersson IF, Coster L, Waltbrand E. Addition of infliximab compared with addition of sulfasalazine and hydroxychloroquine to methotrexate in patients with early rheumatoid arthritis (Swefot trial): 1-year results of a randomised trial. Lancet. 2009 Aug 8. 374(9688):459-66. [Medline].

81. Visser K, van der Heijde D. Optimal dosage and route of administration of methotrexate in rheumatoid arthritis: a systematic review of the literature. Ann Rheum Dis. 2009 Jul. 68(7):1094-9. [Medline]. [Full Text].

82. Keystone EC, Kavanaugh A, Weinblatt ME, Patra K, Pangan AL. Clinical consequences of delayed addition of adalimumab to methotrexate therapy over 5 years in patients with rheumatoid arthritis. J Rheumatol. 2011 May. 38(5):855-62. [Medline].

83. Kelly J. Rheumatoid Arthritis: Target Adalimumab Level Determined. Medscape Medical News. Available at http://www.medscape.com/viewarticle/818102. Accessed: December 23, 2013.

84. Pouw MF, Krieckaert CL, Nurmohamed MT, et al. Key findings towards optimising adalimumab treatment: the concentration-effect curve. Ann Rheum Dis. 2015 Mar. 74(3):513-8. [Medline].

85. Fleischmann R, Vencovsky J, van Vollenhoven RF, Borenstein D, Box J, Coteur G. Efficacy and safety of certolizumab pegol monotherapy every 4 weeks in patients with rheumatoid arthritis failing previous disease-modifying antirheumatic therapy: the FAST4WARD study. Ann Rheum Dis. 2009 Jun. 68(6):805-11. [Medline]. [Full Text].

86. Smolen J, Landewe RB, Mease P, Brzezicki J, Mason D, Luijtens K. Efficacy and safety of certolizumab pegol plus methotrexate in active rheumatoid arthritis: the RAPID 2 study. A randomised controlled trial. Ann Rheum Dis. 2009 Jun. 68(6):797-804. [Medline]. [Full Text].

87. Emery P, Fleischmann RM, Moreland LW, Hsia EC, Strusberg I, Durez P. Golimumab, a human anti-tumor necrosis factor alpha monoclonal antibody, injected subcutaneously every four weeks in methotrexate-naive patients with active rheumatoid arthritis: twenty-four-week results of a phase III, multicenter, randomized, double-blind, placebo-controlled study of golimumab before methotrexate as first-line therapy for early-onset rheumatoid arthritis. Arthritis Rheum. 2009 Aug. 60(8):2272-83. [Medline].

88. Brown T. FDA approves intravenous golimumab (Simponi Aria) for rheumatoid arthritis. Medscape Medical News. July 18, 2013. [Full Text].

89. Janssen Biotech, Inc. Simponi Aria (golimumab) for infusion receives FDA approval for treatment of moderately to severely active rheumatoid arthritis [press release]. July 18, 2013. [Full Text].

90. Weinblatt ME, Bingham CO 3rd, Mendelsohn AM, et al. Intravenous golimumab is effective in patients with active rheumatoid arthritis despite methotrexate therapy with responses as early as week 2: results of the phase 3, randomised, multicentre, double-blind, placebo-controlled GO-FURTHER trial. Ann Rheum Dis. 2013 Mar. 72(3):381-9. [Medline].

91. Edwards JC, Szczepanski L, Szechinski J, Filipowicz-Sosnowska A, Emery P, Close DR. Efficacy of B-cell-targeted therapy with rituximab in patients with rheumatoid arthritis. N Engl J Med. 2004 Jun 17. 350(25):2572-81. [Medline].

92. Peterfy C, Emery P, Tak PP, Østergaard M, DiCarlo J, Otsa K, et al. MRI assessment of suppression of structural damage in patients with rheumatoid arthritis receiving rituximab: results from the randomised, placebo-controlled, double-blind RA-SCORE study. Ann Rheum Dis. 2016 Jan. 75 (1):170-7. [Medline]. [Full Text].

93. Emery P, Gottenberg JE, Rubbert-Roth A, et al. Rituximab versus an alternative TNF inhibitor in patients with rheumatoid arthritis who failed to respond to a single previous TNF inhibitor: SWITCH-RA, a global, observational, comparative effectiveness study. Ann Rheum Dis. 2015 Jun. 74(6):979-84. [Medline].

94. Porter D, van Melckebeke J, Dale J, Messow CM, McConnachie A, Walker A, et al. Tumour necrosis factor inhibition versus rituximab for patients with rheumatoid arthritis who require biological treatment (ORBIT): an open-label, randomised controlled, non-inferiority, trial. Lancet. 2016 Jul 16. 388 (10041):239-47. [Medline].

95. Bingham CO 3rd, Looney RJ, Deodhar A, Halsey N, Greenwald M, Codding C. Immunization responses in rheumatoid arthritis patients treated with rituximab: results from a controlled clinical trial. Arthritis Rheum. 2010 Jan. 62(1):64-74. [Medline].

96. Orencia (abatacept) [package insert]. Princeton, NJ: Bristol-Myers Squibb. 2011. Available at [Full Text].

97. Genovese MC, Schiff M, Luggen M, et al. Longterm safety and efficacy of abatacept through 5 years of treatment in patients with rheumatoid arthritis and an inadequate response to tumor necrosis factor inhibitor therapy. J Rheumatol. Aug 2012. 39(8):1546-54. [Medline].

98. Weinblatt ME, Schiff M, Valente R, et al. Head-to-head comparison of subcutaneous abatacept versus adalimumab for rheumatoid arthritis: Findings of a phase IIIb, multinational, prospective, randomized study. Arthritis Rheum. 2013 Jan. 65(1):28-38. [Medline].

99. Dougados M, Kissel K, Sheeran T, et al. Adding tocilizumab or switching to tocilizumab monotherapy in methotrexate inadequate responders: 24-week symptomatic and structural results of a 2-year randomised controlled strategy trial in rheumatoid arthritis (ACT-RAY). Ann Rheum Dis. Jul 7 2012. [Medline].

100. Strand V, Burmester GR, Ogale S, Devenport J, John A, Emery P. Improvements in health-related quality of life after treatment with tocilizumab in patients with rheumatoid arthritis refractory to tumour necrosis factor inhibitors: results from the 24-week randomized controlled RADIATE study. Rheumatology (Oxford). Jun 28 2012. [Medline].

101. Burmester GR, Rubbert-Roth A, Cantagrel A, et al. A randomised, double-blind, parallel-group study of the safety and efficacy of subcutaneous tocilizumab versus intravenous tocilizumab in combination with traditional disease-modifying antirheumatic drugs in patients with moderate to severe rheumatoid arthritis (SUMMACTA study). Ann Rheum Dis. 2014 Jan. 73(1):69-74. [Medline].

102. Smolen JS, Schoels MM, Nishimoto N, et al. Consensus statement on blocking the effects of interleukin-6 and in particular by interleukin-6 receptor inhibition in rheumatoid arthritis and other inflammatory conditions. Ann Rheum Dis. 2013 Apr. 72(4):482-92. [Medline].

103. Genovese MC, Fleischmann R, Kivitz AJ, Rell-Bakalarska M, Martincova R, Fiore S, et al. Sarilumab Plus Methotrexate in Patients With Active Rheumatoid Arthritis and Inadequate Response to Methotrexate: Results of a Phase III Study. Arthritis Rheumatol. 2015 Jun. 67 (6):1424-37. [Medline]. [Full Text].

104. Fleischmann R, van Adelsberg J, Lin Y, Castelar-Pinheiro GD, Brzezicki J, Hrycaj P, et al. Sarilumab and Nonbiologic Disease-Modifying Antirheumatic Drugs in Patients With Active Rheumatoid Arthritis and Inadequate Response or Intolerance to Tumor Necrosis Factor Inhibitors. Arthritis Rheumatol. 2017 Feb. 69 (2):277-290. [Medline]. [Full Text].

105. Fleischmann R. Novel small-molecular therapeutics for rheumatoid arthritis. Curr Opin Rheumatol. 2012 May. 24(3):335-41. [Medline].

106. FDA approves Xeljanz for rheumatoid arthritis [press release]. November 6, 2012. Available at http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm327152.htm. Accessed: November 28, 2012.

107. van der Heijde D, Tanaka Y, Fleischmann R, et al; ORAL Scan Investigators. Tofacitinib (CP-690,550) in patients with rheumatoid arthritis receiving methotrexate: twelve-month data from a twenty-four-month phase III randomized radiographic study. Arthritis Rheum. 2013 Mar. 65(3):559-70. [Medline].

108. Fleischmann R, Kremer J, Cush J, et al. Placebo-controlled trial of tofacitinib monotherapy in rheumatoid arthritis. N Engl J Med. Aug 9 2012. 367(6):495-507. [Medline].

109. van Vollenhoven RF, Fleischmann R, Cohen S, et al. Tofacitinib or adalimumab versus placebo in rheumatoid arthritis. N Engl J Med. Aug 9 2012. 367(6):508-19. [Medline].

110. Brown T. FDA Approves Baricitinib for Rheumatoid Arthritis. Medscape Medical News. 2018 Jun 01. Available at https://www.medscape.com/viewarticle/897516.

111. Dougados M, van der Heijde D, Chen YC, Greenwald M, Drescher E, Liu J, et al. Baricitinib in patients with inadequate response or intolerance to conventional synthetic DMARDs: results from the RA-BUILD study. Ann Rheum Dis. 2017 Jan. 76 (1):88-95. [Medline]. [Full Text].

112. van der Heijde D, Dougados M, Chen YC, Greenwald M, Drescher E, Klar R, et al. Effects of baricitinib on radiographic progression of structural joint damage at 1 year in patients with rheumatoid arthritis and an inadequate response to conventional synthetic disease-modifying antirheumatic drugs. RMD Open. 2018. 4 (1):e000662. [Medline]. [Full Text].

113. Smolen JS, Kremer JM, Gaich CL, DeLozier AM, Schlichting DE, Xie L, et al. Patient-reported outcomes from a randomised phase III study of baricitinib in patients with rheumatoid arthritis and an inadequate response to biological agents (RA-BEACON). Ann Rheum Dis. 2017 Apr. 76 (4):694-700. [Medline]. [Full Text].

114. Smolen JS, Pangan AL, Emery P, Rigby W, Tanaka Y, Vargas JI, et al. Upadacitinib as monotherapy in patients with active rheumatoid arthritis and inadequate response to methotrexate (SELECT-MONOTHERAPY): a randomised, placebo-controlled, double-blind phase 3 study. Lancet. 2019 Jun 8. 393 (10188):2303-2311. [Medline].

115. Fleischmann RM, Genovese MC, Enejosa JV, Mysler E, Bessette L, Peterfy C, et al. Safety and effectiveness of upadacitinib or adalimumab plus methotrexate in patients with rheumatoid arthritis over 48 weeks with switch to alternate therapy in patients with insufficient response. Ann Rheum Dis. 2019 Jul 30. [Medline]. [Full Text].

116. Tosh JC, Wailoo AJ, Scott DL, Deighton CM. Cost-effectiveness of combination nonbiologic disease-modifying antirheumatic drug strategies in patients with early rheumatoid arthritis. J Rheumatol. 2011 Aug. 38(8):1593-600. [Medline].

117. Lipsky PE, van der Heijde DM, St Clair EW, et al. Infliximab and methotrexate in the treatment of rheumatoid arthritis. Anti-Tumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy Study Group. N Engl J Med. 2000 Nov 30. 343(22):1594-602. [Medline].

118. Rigby W, Ferraccioli G, Greenwald M, et al. Effect of rituximab on physical function and quality of life in patients with rheumatoid arthritis previously untreated with methotrexate. Arthritis Care Res (Hoboken). 2011 May. 63(5):711-20. [Medline].

119. O'Dell JR, Haire CE, Erikson N, et al. Treatment of rheumatoid arthritis with methotrexate alone, sulfasalazine and hydroxychloroquine, or a combination of all three medications. N Engl J Med. 1996 May 16. 334(20):1287-91. [Medline].

120. Emery P, Horton S, Dumitru RB, Naraghi K, van der Heijde D, Wakefield RJ, et al. Pragmatic randomised controlled trial of very early etanercept and MTX versus MTX with delayed etanercept in RA: the VEDERA trial. Ann Rheum Dis. 2020 Jan 29. [Medline]. [Full Text].

121. Jones SK. Ocular toxicity and hydroxychloroquine: guidelines for screening. Br J Dermatol. 1999 Jan. 140(1):3-7. [Medline].

122. Bongartz T, Sutton AJ, Sweeting MJ, Buchan I, Matteson EL, Montori V. Anti-TNF antibody therapy in rheumatoid arthritis and the risk of serious infections and malignancies: systematic review and meta-analysis of rare harmful effects in randomized controlled trials. JAMA. 2006 May 17. 295(19):2275-85. [Medline].

123. Sohl S, Renner R, Winter U, et al. [Drug-induced lupus erythematosus tumidus during treatment with adalimumab]. Hautarzt. 2009 Oct. 60(10):826-9. [Medline].

124. Ramos-Casals M, Brito-Zeron P, Soto MJ, Cuadrado MJ, Khamashta MA. Autoimmune diseases induced by TNF-targeted therapies. Best Pract Res Clin Rheumatol. 2008 Oct. 22(5):847-61. [Medline].

125. Lunt M, Watson KD, Dixon WG, Symmons DP, Hyrich KL. No evidence of association between anti-tumor necrosis factor treatment and mortality in patients with rheumatoid arthritis: results from the British Society for Rheumatology Biologics Register. Arthritis Rheum. 2010 Nov. 62(11):3145-53. [Medline].

126. Thompson AE, Rieder SW, Pope JE. Tumor necrosis factor therapy and the risk of serious infection and malignancy in patients with early rheumatoid arthritis: A meta-analysis of randomized controlled trials. Arthritis Rheum. 2011 Jun. 63(6):1479-85. [Medline].

127. Mariette X, Matucci-Cerinic M, Pavelka K, et al. Malignancies associated with tumour necrosis factor inhibitors in registries and prospective observational studies: a systematic review and meta-analysis. Ann Rheum Dis. 2011 Nov. 70(11):1895-904. [Medline].

128. Hoes JN, Jacobs JW, Buttgereit F, Bijlsma JW. Current view of glucocorticoid co-therapy with DMARDs in rheumatoid arthritis. Nat Rev Rheumatol. 2010 Dec. 6(12):693-702. [Medline].

129. Buttgereit F, Doering G, Schaeffler A, et al. Efficacy of modified-release versus standard prednisone to reduce duration of morning stiffness of the joints in rheumatoid arthritis (CAPRA-1): a double-blind, randomised controlled trial. Lancet. Jan 19 2008. 371(9608):205-14. [Medline].

130. Buttgereit F, Doering G, Schaeffler A, et al. Targeting pathophysiological rhythms: prednisone chronotherapy shows sustained efficacy in rheumatoid arthritis. Ann Rheum Dis. Jul 2010. 69(7):1275-80. [Medline]. [Full Text].

131. Buttgereit F, Mehta D, Kirwan J, et al. Low-dose prednisone chronotherapy for rheumatoid arthritis: a randomised clinical trial (CAPRA-2). Ann Rheum Dis. 2013 Feb. 72(2):204-10. [Medline]. [Full Text].

132. Boggs W. Infliximab, steroids offer similar RA remission rates. Medscape Medical News. August 28, 2013. [Full Text].

133. Nam JL, Villeneuve E, Hensor EM, et al. Remission induction comparing infliximab and high-dose intravenous steroid, followed by treat-to-target: a double-blind, randomised, controlled trial in new-onset, treatment-naive, rheumatoid arthritis (the IDEA study). Ann Rheum Dis. 2014 Jan. 73(1):75-85. [Medline].

134. Myasoedova E, Crowson CS, Nicola PJ, et al. The influence of rheumatoid arthritis disease characteristics on heart failure. J Rheumatol. 2011 Aug. 38(8):1601-6. [Medline].

135. Solomon SD, Wittes J, Finn PV, et al, for the Cross Trial Safety Assessment Group. Cardiovascular risk of celecoxib in 6 randomized placebo-controlled trials: the cross trial safety analysis. Circulation. 2008 Apr 22. 117(16):2104-13. [Medline].

136. Weinblatt ME, Kavanaugh A, Genovese MC, Musser TK, Grossbard EB, Magilavy DB. An oral spleen tyrosine kinase (Syk) inhibitor for rheumatoid arthritis. N Engl J Med. 2010 Sep. 363(14):1303-12. [Medline].

137. Ince-Askan H, Dolhain RJ. Pregnancy and rheumatoid arthritis. Best Pract Res Clin Rheumatol. 2015 Aug-Dec. 29 (4-5):580-96. [Medline].

138. Ostensen M, Forger F, Nelson JL, Schuhmacher A, Hebisch G, Villiger PM. Pregnancy in patients with rheumatic disease: anti-inflammatory cytokines increase in pregnancy and decrease post partum. Ann Rheum Dis. 2005 Jun. 64(6):839-44. [Medline].

139. Makol A, Wright K, Amin S. Rheumatoid arthritis and pregnancy: safety considerations in pharmacological management. Drugs. 2011 Oct 22. 71(15):1973-87. [Medline].

140. Parke A, West B. Hydroxychloroquine in pregnant patients with systemic lupus erythematosus. J Rheumatol. 1996 Oct. 23(10):1715-8. [Medline].

141. Temprano KK, Bandlamudi R, Moore TL. Antirheumatic drugs in pregnancy and lactation. Semin Arthritis Rheum. 2005 Oct. 35(2):112-21. [Medline].

142. Androulakis I, Zavos C, Christopoulos P, Mastorakos G, Gazouli M. Safety of anti-tumor necrosis factor therapy during pregnancy in patients with inflammatory bowel disease. World J Gastroenterol. 2015 Dec 21. 21 (47):13205-11. [Medline].

143. Bröms G, Granath F, Ekbom A, Hellgren K, Pedersen L, Sørensen HT, et al. Low Risk of Birth Defects for Infants Whose Mothers Are Treated With Anti-Tumor Necrosis Factor Agents During Pregnancy. Clin Gastroenterol Hepatol. 2016 Feb. 14 (2):234-41.e1-5. [Medline].

144. Luqmani R, Hennell S, Estrach C, et al. British Society for Rheumatology and British Health Professionals in Rheumatology guideline for the management of rheumatoid arthritis (after the first 2 years). Rheumatology (Oxford). 2009 Apr. 48(4):436-9. [Medline].

145. Goksel Karatepe A, Gunaydin R, Turkmen G, Kaya T. Effects of home-based exercise program on the functional status and the quality of life in patients with rheumatoid arthritis: 1-year follow-up study. Rheumatol Int. 2011 Feb. 31(2):171-6. [Medline].

146. Kamioka H, Tsutani K, Okuizumi H, Mutoh Y, Ohta M, Handa S. Effectiveness of aquatic exercise and balneotherapy: a summary of systematic reviews based on randomized controlled trials of water immersion therapies. J Epidemiol. 2010. 20(1):2-12. [Medline].

147. Katz P, Margaretten M, Gregorich S, Trupin L. Physical Activity to Reduce Fatigue in Rheumatoid Arthritis: A Randomized, Controlled Trial. Arthritis Care Res (Hoboken). 2017 Apr 5. [Medline].

148. Lemmey AB, Marcora SM, Chester K, Wilson S, Casanova F, Maddison PJ. Effects of high-intensity resistance training in patients with rheumatoid arthritis: a randomized controlled trial. Arthritis Rheum. 2009 Dec 15. 61(12):1726-34. [Medline].

149. O'Brien ET. Surgical principles and planning for the rheumatoid hand and wrist. Clin Plast Surg. 1996 Jul. 23(3):407-20. [Medline].

150. Macedo AM, Oakley SP, Panayi GS, Kirkham BW. Functional and work outcomes improve in patients with rheumatoid arthritis who receive targeted, comprehensive occupational therapy. Arthritis Rheum. 2009 Nov 15. 61(11):1522-30. [Medline].

151. Williams SB, Brand CA, Hill KD, Hunt SB, Moran H. Feasibility and outcomes of a home-based exercise program on improving balance and gait stability in women with lower-limb osteoarthritis or rheumatoid arthritis: a pilot study. Arch Phys Med Rehabil. 2010 Jan. 91(1):106-14. [Medline].

152. [Guideline] Combe B, Landewe R, Daien CI, et al. 2016 update of the EULAR recommendations for the management of early arthritis. Ann Rheum Dis. 2016 Dec 15. [Medline]. [Full Text].

153. Nordberg LB, Lillegraven S, Lie E, Aga AB, Olsen IC, Hammer HB, et al. Patients with seronegative RA have more inflammatory activity compared with patients with seropositive RA in an inception cohort of DMARD-naïve patients classified according to the 2010 ACR/EULAR criteria. Ann Rheum Dis. 2017 Feb. 76 (2):341-345. [Medline].

154. Ahlmen M, Svensson B, Albertsson K, Forslind K, Hafstrom I, BARFOT Study Group. Influence of gender on assessments of disease activity and function in early rheumatoid arthritis in relation to radiographic joint damage. Ann Rheum Dis. 2010 Jan. 69(1):230-3. [Medline].

155. Kineret [package insert] [package insert]. Amgen. Personal communication with Kijung Sung-Thay, PharmD. 2008.

156. Axelsen MB, Eshed I, Horslev-Petersen K, et al; OPERA study group. A treat-to-target strategy with methotrexate and intra-articular triamcinolone with or without adalimumab effectively reduces MRI synovitis, osteitis and tenosynovitis and halts structural damage progression in early rheumatoid arthritis: results from the OPERA randomised controlled trial. Ann Rheum Dis. 2015 May. 74(5):867-75. [Medline].

157. Callhoff J, Weiss A, Zink A, Listing J. Impact of biologic therapy on functional status in patients with rheumatoid arthritis--a meta-analysis. Rheumatology (Oxford). 2013 Dec. 52(12):2127-35. [Medline].

158. Chambers CD, Johnson DL, Luo Y, Xu R, Jones KL. Pregnancy outcomes in women exposed to adalimumab: an update on the OTIS Autoimmune Diseases in Pregnancy project. American College of Rheumatology. Available at http://acrabstracts.org/abstract/pregnancy-outcome-in-women-treated-with-adalimumab-for-the-treatment-of-rheumatoid-arthritis-an-update/. 2014 ACR/ARHP Annual Meeting.Abstract Number: 821; Accessed: April 6, 2017.

159. [Guideline] Sammaritano LR, Bermas BL, Chakravarty EE, et al. 2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases. Arthritis Rheumatol. 2020 Feb 23. [Medline]. [Full Text].

Howard R Smith, MD Director of the Lupus Clinic, Department of Rheumatic and Immunologic Diseases, Cleveland Clinic

Howard R Smith, MD is a member of the following medical societies: American College of Rheumatology

Disclosure: Nothing to disclose.

Adam Brown, MD Fellow, Department of Rheumatology, Cleveland Clinic

Adam Brown, MD is a member of the following medical societies: American College of Rheumatology, American Medical Association

Disclosure: Nothing to disclose.

Herbert S Diamond, MD Visiting Professor of Medicine, Division of Rheumatology, State University of New York Downstate Medical Center; Chairman Emeritus, Department of Internal Medicine, Western Pennsylvania Hospital

Herbert S Diamond, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American College of Rheumatology, American Medical Association, Phi Beta Kappa

Disclosure: Nothing to disclose.

Katherine K Temprano, MD Assistant Professor of Internal Medicine, Division of Rheumatology, St Louis University School of Medicine

Katherine K Temprano, MD is a member of the following medical societies: American College of Physicians-American Society of Internal Medicine, American College of Rheumatology

Disclosure: Partner received honoraria from Baxter for speaking and teaching.

Edward Bessman, MD Chairman, Department of Emergency Medicine, John Hopkins Bayview Medical Center; Assistant Professor, Department of Emergency Medicine, Johns Hopkins University School of Medicine

Edward Bessman, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Sarjoo M Bhagia, MD Consulting Staff, OrthoCarolina; Voluntary Teaching Faculty, Carolinas Rehabilitation

Sarjoo M Bhagia, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Association of Academic Physiatrists, North American Spine Society, and Physiatric Association of Spine, Sports and Occupational Rehabilitation

Disclosure: Nothing to disclose.

Heather Lyn Carone, MD Attending Physician, Department of Emergency Medicine, St Vincent Mercy Medical Center

Heather Lyn Carone, MD is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Gino A Farina, MD, FACEP, FAAEM Associate Professor of Clinical Emergency Medicine, Albert Einstein College of Medicine; Program Director, Department of Emergency Medicine, Long Island Jewish Medical Center

Gino A Farina, MD, FACEP, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Patrick M Foye, MD Associate Professor of Physical Medicine and Rehabilitation, Co-Director of Musculoskeletal Fellowship, Co-Director of Back Pain Clinic, Director of Coccyx Pain Service (Tailbone Pain Service: www.TailboneDoctor.com), University of Medicine and Dentistry of New Jersey, New Jersey Medical School

Patrick M Foye, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, Association of Academic Physiatrists, and International Spine Intervention Society

Disclosure: Nothing to disclose.

Harris Gellman, MD Consulting Surgeon, Broward Hand Center; Voluntary Clinical Professor of Orthopedic Surgery and Plastic Surgery, Departments of Orthopedic Surgery and Surgery, University of Miami, Leonard M Miller School of Medicine

Harris Gellman, MD is a member of the following medical societies: American Academy of Medical Acupuncture, American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Society for Surgery of the Hand, and Arkansas Medical Society

Disclosure: Nothing to disclose.

Elliot Goldberg, MD Dean of the Western Pennsylvania Clinical Campus, Professor, Department of Medicine, Temple University School of Medicine

Elliot Goldberg, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, and American College of Rheumatology

Disclosure: Nothing to disclose.

Kavita Gupta, DO, MEng Department of Orthopedics, Center of Physical Medicine and Rehabilitation, University of Dentistry and Medicine of New Jersey

Kavita Gupta, DO, MEng is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Osteopathic Association, Association of Academic Physiatrists, and Pennsylvania Medical Society

Disclosure: Nothing to disclose.

John A Kare, MD Assistant Professor of Emergency Medicine, Charles R Drew University of Medicine and Science/UCLA, Director of Research, Department of Emergency Medicine, Martin Luther King Jr/Charles R Drew Medical Center

John A Kare, MD is a member of the following medical societies: American Academy of Emergency Medicine, American Medical Student Association/Foundation, and Emergency Medicine Residents Association

Disclosure: Nothing to disclose.

Randall W King, MD, FACEP Assistant Clinical Professor of Emergency Medicine, The University of Toledo College of Medicine; Director, Emergency Medicine Residency Program, Associate Chair, Department of Emergency Medicine, St Vincent Mercy Medical Center

Randall W King, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, Council of Emergency Medicine Residency Directors, Ohio State Medical Association, and Society for Academic Emergency Medicine

Disclosure: Challenger corporation None Physician Advisory Board; Ohio ACEP Consulting fee Editor Rivers review text Emergency Medicine

Milton J Klein, DO, MBA Consulting Physiatrist, Heritage Valley Health System-Sewickley Hospital and Ohio Valley General Hospital

Milton J Klein, DO, MBA is a member of the following medical societies: American Academy of Disability Evaluating Physicians, American Academy of Medical Acupuncture, American Academy of Osteopathy, American Academy of Physical Medicine and Rehabilitation, American Medical Association, American Osteopathic Association, American Osteopathic College of Physical Medicine and Rehabilitation, American Pain Society, and Pennsylvania Medical Society

Disclosure: Nothing to disclose.

Kristine M Lohr, MD, MS Professor, Department of Internal Medicine, Center for the Advancement of Women's Health and Division of Rheumatology, Director, Rheumatology Training Program, University of Kentucky College of Medicine

Kristine M Lohr, MD, MS is a member of the following medical societies: American College of Physicians and American College of Rheumatology

Disclosure: Nothing to disclose.

Robert J Nowinski, DO Clinical Assistant Professor of Orthopaedic Surgery, Ohio State University College of Medicine and Public Health, Ohio University College of Osteopathic Medicine; Private Practice, Orthopedic and Neurological Consultants, Inc, Columbus, Ohio

Robert J Nowinski, DO is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Osteopathic Surgeons, American Medical Association, American Osteopathic Association, Ohio Osteopathic Association, and Ohio State Medical Association

Disclosure: Tornier Grant/research funds Other; Tornier Honoraria Speaking and teaching

Robert E O'Connor, MD, MPH Professor and Chair, Department of Emergency Medicine, University of Virginia Health System

Robert E O'Connor, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Physician Executives, American Heart Association, American Medical Association, Medical Society of Delaware, National Association of EMS Physicians, Society for Academic Emergency Medicine, and Wilderness Medical Society

Disclosure: Nothing to disclose.

Elizabeth Salt, ARPN, PhD Assistant Professor, Division of Rheumatology, University of Kentucky College of Nursing; Rheumatology Nurse Practitioner, University of Kentucky Chandler Medical Center

Elizabeth Scarbrough, MSN is a member of the following medical societies: American College of Rheumatology, Council for the Advancement of Nursing Science, and Sigma Theta Tau International

Disclosure: Nothing to disclose.

Roberto Sandoval, MD Consulting Staff, Department of Emergency Medicine, Anaheim Memorial Medical Center, La Palma Intercommunity Hospital

Roberto Sandoval, MD is a member of the following medical societies: American College of Emergency Physicians and American Medical Association

Disclosure: Nothing to disclose.

Joseph E Sheppard, MD Professor of Clinical Orthopedic Surgery, Chief of Hand and Upper Extremity Service, Department of Orthopedic Surgery, University of Arizona Health Sciences Center, University Physicians Healthcare

Joseph E Sheppard, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Society for Surgery of the Hand, and Orthopaedics Overseas

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Roman V Voytsekhovskiy, MD Fellow in Hand Surgery, Department of Orthopedic Surgery, Rush University Medical Center

Disclosure: Nothing to disclose.

Eleby R Washington III, MD, FACS Associate Professor, Department of Surgery, Division of Orthopedics, Charles R Drew University of Medicine and Science

Eleby R Washington III, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons, American Medical Association, International College of Surgeons, and National Medical Association

Disclosure: Nothing to disclose.

Richard Worthington MD, Department of Emergency Medicine, Wood County Hospital

Richard Worthington is a member of the following medical societies: American College of Emergency Physicians, Ohio State Medical Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.