Assessment of rheumatoid arthritis--a clinician's viewpoint.

There are many measures that can be used for the short and longterm monitoring of patients with rheumatoid arthritis (RA). An important requirement for such assessments is the development of new pharmacologic therapies. It is important to assess the need for and the outcome of therapy. In recent years, it has been realized that subjective assessments have many advantages over objective ones. However, in the majority of cases subjective measures and objective measures parallel each other closely. The measurement of acute phase protein, in particular C-reactive protein (CRP), is helpful as an indicator of successful therapy. From data regarding axial osteoporosis, CRP has been shown to be a convenient marker indicating persistent active disease that will produce catabolic effects. Dual energy X-ray absorption scans have also been shown to be promising in objectively measuring change in the hand for patients with inflammatory arthritis. In patients presenting early with RA, it is necessary to have accurate indicators. In this respect, genetic predictors have a particular value. The most important aspect of the assessment of RA is subjective impressions. Therefore, a functional questionnaire such as the health assessment questionnaire combined with the objective measure of choice, CRP levels, are the assessments of choice.