consider a consultation with a rheumatologit in the case of progressive disease
Perform an intramuscular injuction of z ml of K40 to reduce the mild to moderate lane. prescribe wold salt hydrooychloeoquine diaquenin, penicillamine, or metho tri cate for the progressive or advanced case use a moderate dose of oral prednisone for 1 to 2 months with a slow taper reduce the interality of a moderate to severe flare 00 to 40 mg per day, tapering by s mg until 10 to 15 mg is reached and then by i to 2 mg mments until the course is completed: when tapeting never reduce the dose by more than 10 to 15y, Limat narcotics to severe flares and to a pecified number per week or month Avoid chronic use of oral corticostenoids sum(w rs sr arthritish Repu t orthopedic consultation for joint replace met when severe deformity accompanies dramatic functional impairment PHYSICAL THERAPY mysoal and occupational therapy play a very important overall maragement of RA, especially in the late stige in the lier any acutely inflamed ynint 1