What Can We Tell Our Patients About Rheumatoid Arthritis Risk?

Authors

  • Liam O’Neil, MD, MHSc, FRCPC University of Manitoba, Department of Internal Medicine, Winnipeg, Canada
  • Hani El-Gabalawy, MD, FRCPC University of Manitoba, Department of Internal Medicine, Winnipeg, Canada

DOI:

https://doi.org/10.58931/crt.2025.2265

Abstract

You are seeing a 45-year-old female with a chief complaint of joint pain in the hands and feet. The symptoms have been apparent for 6 months. There was no preceding illness. She reports morning stiffness of the affected joints. The patient denies any joint swelling. Her medical history is notable for a strong family history of Rheumatoid Arthritis, and she currently smokes one pack of cigarettes daily. On physical examination, the joints appear normal, with full range of motion and no obvious tenderness to palpation. There is no evidence of synovitis or rashes. Laboratory investigations show elevated anti-citrullinated protein antibody level of 135, and her rheumatoid factor level is 45. C-reactive protein is within normal limits. Radiographs of the hands and feet are normal.

Questions:

1. What is her likelihood of developing rheumatoid arthritis within the next 3 years?

2. Are there any other tests you need to order?

3. Can rheumatoid arthritis be prevented in this individual? What advice can you provide her?

Author Biographies

Liam O’Neil, MD, MHSc, FRCPC, University of Manitoba, Department of Internal Medicine, Winnipeg, Canada

Dr. Liam O’Neil is an Assistant Professor of Medicine and Immunology at the University of Manitoba in Winnipeg, Canada. His research program aims to understand the pre-clinical Rheumatoid Arthritis period by interfacing proteomics and systems immunology. He is the NPI of a longitudinal research cohort of ACPA positive individuals without RA, who are monitored for
disease onset.

Hani El-Gabalawy, MD, FRCPC, University of Manitoba, Department of Internal Medicine, Winnipeg, Canada

Dr. Hani El‑Gabalawy, MD, FRCPC is a Professor of Medicine and Immunology at the University of Manitoba, where he also holds the Endowed Rheumatology Research Chair and serves as a senior clinician‑scientist. His research focuses on the immunopathogenesis and prevention of rheumatoid arthritis, specifically through collaborative research with First Nations communities.

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Published

2025-08-28

How to Cite

1.
O’Neil L, El-Gabalawy H. What Can We Tell Our Patients About Rheumatoid Arthritis Risk?. Can Rheumatol Today [Internet]. 2025 Aug. 28 [cited 2025 Aug. 31];2(2):32–35. Available from: https://canadianrheumatologytoday.com/article/view/2-2-ONeil_et_al

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Volume 2, Issue 2, Summer 2025

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