Rheumatoid Arthritis and its Mimickers: A Review

Rheumatoid arthritis (RA) is the most common chronic inflammatory arthritis associated with significant morbidity and physical disability in large number of patients. It has a wide clinical spectrum, which varies from mild joint symptoms to severe inflammation leading to joint damage with or without significant number of extra-articular manifestations. However, diagnosis of RA predominantly relies on clinical presentation but blood investigations and joint imaging have significant supporting role in making the diagnosis. There are lots of clinical conditions that may have similar presentation like RA, which should ideally be ruled out before labeling one as having RA to avoid unreasonable exposure to toxic DMARD therapy. Apart from these mimicking conditions, there are certain situations such as atypical presentations of RA; irrational steroid prescriptions masking the clinical signs of RA, coexisting obesity, which make the diagnosis troublesome leading to undesirable delay in the initiation of specific therapy. The narratives of this review are to highlight these mimickers and their characteristic features distinguishing them from RA, which may help the clinicians to deal with RA patients in more efficient manner and ruling out different disease conditions carrying the similar presentation. We understand that knowledge of these conditions and their presentation, diagnosis, and management may ultimately improve patient outcomes.