Name

Birth Date

Age

Gender

Male Female

Residency

--< Select >-- Cairo Giza Alexandria Port Said Suez Demiatt Dakahlia Sharkia Qalyoubia Kafr Shaikh Gharbia Menouffia Behaira Ismaillia Beni Suif Fayoum Minia Assuit Sohag Qena Asswan Luxor Al Bahr Al Ahmar Al Wadi Al Gaddid Matrouh N. Sinai S. Sinai Other Country

Occupation

Weight (kg)

Height (m)

BMI (Body Mass Index)

Smoking

Yes No

Family history of RA

Yes No

Informed Consent

History of Major infection

Yes No

HLA DR4

Yes No

Morning Stiffness (in minutes)

Arthritis of the Hands / Wrist

Yes No

Arthritis of Ankle / Foot

Yes No

Arthitis of Other Joints

Yes No

If yes, Clarify which joints affected??

Hand Defornities

Swan Neck Boutonniere Z-Shaped thumb Ulnar deviation of the wrist Piano sign Other deformities Combinations

Foot Deformities

Hammer Toe Claw Toe Hallux Valgus

Entrapment neuropathy

Yes No

If yes, Clarify which entrapment neuropathy?

Mononeuritis multiplex

Yes No

Atlantoaxial Sublaxation

Yes No

Pleurisy

Yes No

Pleural effusion

Yes No

Interstitial Pulmonary Fibrosis (IPF)

Yes No

Atherosclersis

Yes No

ischemic heart disease

Yes No

Pericardial Effusion

Yes No

Scleritis

Yes No

Episcleritis

Yes No

Sjogren's $

Yes No

Subcutaneous nodules

Yes No

Osteoporosis

Yes No

Amyloidosis

Yes No

CBC

ESR

CRP

RF

Positive Negative

Anti-CCP

Positive Negative

Anti MCV

Positive Negative

Kidney Function Tests

Normal Abnormal

Liver Function Tests

Normal Abnormal

X-ray Hands and Wrists

X-ray Foot and Ankle

X-ray Chest

MRI Extremities

MSUS

NMUS

DEXA

Normal Osteopenia Osteoporosis Severe Osteoporosis

CDAI

SCDAI

DAS

DAS-28

Tender joint count (0-28)

Swollen joint count (0-28)

Patient global assessment (VAS in cm)

ESR (mm/h)

NSAIDs

DMARDS

Methotrexate Leflunomide Sulphasalazine Hydroxychloroquine

Corticosteroids

IA glucocorticods injection

Yes No

Anti-TNF drugs

Humira Enbrel Remicade Simponi Cimzia

Other biological drugs