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| __NOTOC__ | | __NOTOC__ |
| {{SI}}
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| {{CMG}}; {{CK}} | | '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' |
| ==Overview==
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| ==Historical Perspective==
| | {{Psoriatic arthritis}} |
| *[Disease name] was first discovered by [scientist name], a [nationality + occupation], in [year] during/following [event].
| | {{CMG}}; {{AE}} {{CK}} |
| *In [year], [gene] mutations were first identified in the pathogenesis of [disease name].
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| *In [year], the first [discovery] was developed by [scientist] to treat/diagnose [disease name].
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| ==Classification==
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| *[Disease name] may be classified according to [classification method] into [number] subtypes/groups:
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| :*[group1]
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| :*[group2]
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| :*[group3]
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| *Other variants of [disease name] include [disease subtype 1], [disease subtype 2], and [disease subtype 3].
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| ==Pathophysiology==
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| *The pathogenesis of [disease name] is characterized by [feature1], [feature2], and [feature3].
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| *The [gene name] gene/Mutation in [gene name] has been associated with the development of [disease name], involving the [molecular pathway] pathway.
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| *On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
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| *On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
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| ==Clinical Features==
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| ==Differentiating [disease name] from other Diseases== | | ==[[Psoriatic arthritis overview|Overview]]== |
| *[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as:
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| :*[Differential dx1]
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| :*[Differential dx2]
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| :*[Differential dx3]
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| ==Epidemiology and Demographics==
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| * The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide.
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| * In [year], the incidence of [disease name] was estimated to be [number or range] cases per 100,000 individuals in [location].
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| ===Age===
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| *Patients of all age groups may develop [disease name].
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| *[Disease name] is more commonly observed among patients aged [age range] years old.
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| *[Disease name] is more commonly observed among [elderly patients/young patients/children].
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| ===Gender===
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| * In general, there is no gender predilection to psoriatic arthritis.
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| ===Race=== | | ==[[Psoriatic arthritis historical perspective|Historical Perspective]]== |
| *There is no racial predilection for [disease name].
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| *[Disease name] usually affects individuals of the [race 1] race.
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| *[Race 2] individuals are less likely to develop [disease name].
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| ==Risk Factors==
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| *Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
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| == Natural History, Complications and Prognosis==
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| *The majority of patients with [disease name] remain asymptomatic for [duration/years].
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| *Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
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| *If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
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| *Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
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| *Prognosis is generally [excellent/good/poor], and the [1/5/10year mortality/survival rate] of patients with [disease name] is approximately [#%].
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| == Diagnosis ==
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| ===Diagnostic Criteria===
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| *The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
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| :*[criterion 1]
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| :*[criterion 2]
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| :*[criterion 3]
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| :*[criterion 4]
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| === Symptoms ===
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| *[Disease name] is usually asymptomatic.
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| *Symptoms of [disease name] may include the following:
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| :*[symptom 1]
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| :*[symptom 2]
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| :*[symptom 3]
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| :*[symptom 4]
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| :*[symptom 5]
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| :*[symptom 6]
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| === Physical Examination ===
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| *Patients with [disease name] usually appear [general appearance].
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| *Physical examination may be remarkable for:
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| :*[finding 1]
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| :*[finding 2]
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| :*[finding 3]
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| :*[finding 4]
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| :*[finding 5]
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| :*[finding 6]
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| === Laboratory Findings ===
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| *There are no specific [[Medical laboratory|laboratory]] findings associated with [[Psoriatic arthritis (patient information)|psoriatic arthritis]] and most the tests are non-specific.
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| *However, there are certain [[Medical laboratory|laboratory]] tests that can check for markers of [[inflammation]] and to exclude other [[Disease|diseases]]. These include:<ref name="pmid17828345">{{cite journal |vauthors=Punzi L, Podswiadek M, Oliviero F, Lonigro A, Modesti V, Ramonda R, Todesco S |title=Laboratory findings in psoriatic arthritis |journal=Reumatismo |volume=59 Suppl 1 |issue= |pages=52–5 |date=2007 |pmid=17828345 |doi= |url=}}</ref>
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| ** [[Complete blood count|CBC]] with differential count
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| *** [[Leukocytosis]]
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| *** [[Anemia|Anaemia]]
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| ** Elevated [[Erythrocyte sedimentation rate|ESR]]
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| ** Elevated [[C-reactive protein|CRP]] (C- reactive protein)
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| ** [[Autoantibody|Autoantibodies]]: The following [[Autoantibody|autoantibodies]] may be found in patients with [[Psoriatic arthritis (patient information)|psoriatic arthritis]].<ref name="pmid15834057">{{cite journal |vauthors=Johnson SR, Schentag CT, Gladman DD |title=Autoantibodies in biological agent naive patients with psoriatic arthritis |journal=Ann. Rheum. Dis. |volume=64 |issue=5 |pages=770–2 |date=May 2005 |pmid=15834057 |pmc=1755477 |doi=10.1136/ard.2004.031286 |url=}}</ref>
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| *** [[Rheumatoid factor]]
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| *** [[Antinuclear antibodies|ANA]] ([[Antinuclear antibodies]])
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| *** Anti-citrullinated peptide antibodies (ACPA)
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| ** Genetic markers:<ref name="pmid23916976">{{cite journal |vauthors=Chandran V, Bull SB, Pellett FJ, Ayearst R, Rahman P, Gladman DD |title=Human leukocyte antigen alleles and susceptibility to psoriatic arthritis |journal=Hum. Immunol. |volume=74 |issue=10 |pages=1333–8 |date=October 2013 |pmid=23916976 |doi=10.1016/j.humimm.2013.07.014 |url=}}</ref><ref name="pmid21900282">{{cite journal |vauthors=Eder L, Chandran V, Pellet F, Shanmugarajah S, Rosen CF, Bull SB, Gladman DD |title=Human leucocyte antigen risk alleles for psoriatic arthritis among patients with psoriasis |journal=Ann. Rheum. Dis. |volume=71 |issue=1 |pages=50–5 |date=January 2012 |pmid=21900282 |doi=10.1136/ard.2011.155044 |url=}}</ref>
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| *** [[HLA-B27]]
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| *** [[HLA-C]]*06
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| ** [[Synovial fluid]] analysis: Elevated [[White blood cells|WBC]] count suggestive of [[inflammation]].
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| ===Imaging Findings=== | | ==[[Psoriatic arthritis classification|Classification]]== |
| * [[X-rays|X-ray]] of digits:<ref name="pmid25231177">{{cite journal |vauthors=McGonagle D, Hermann KG, Tan AL |title=Differentiation between osteoarthritis and psoriatic arthritis: implications for pathogenesis and treatment in the biologic therapy era |journal=Rheumatology (Oxford) |volume=54 |issue=1 |pages=29–38 |date=January 2015 |pmid=25231177 |pmc=4269795 |doi=10.1093/rheumatology/keu328 |url=}}</ref><ref name="pmid16126794">{{cite journal |vauthors=Siannis F, Farewell VT, Cook RJ, Schentag CT, Gladman DD |title=Clinical and radiological damage in psoriatic arthritis |journal=Ann. Rheum. Dis. |volume=65 |issue=4 |pages=478–81 |date=April 2006 |pmid=16126794 |pmc=1798082 |doi=10.1136/ard.2005.039826 |url=}}</ref><ref name="pmid23430715">{{cite journal |vauthors=Haddad A, Chandran V |title=Arthritis mutilans |journal=Curr Rheumatol Rep |volume=15 |issue=4 |pages=321 |year=2013 |pmid=23430715 |doi=10.1007/s11926-013-0321-7 |url=}}</ref>
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| ** Bone destructive changes including formation of subchondral cyst and erosions
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| ** Fluffy periostitis
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| ** [[Ankylosis]]
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| ** [[Phalanx bones|Phalangeal]] tuft [[acroosteolysis]]
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| ** New [[bone]] formation: Perisoteal and endosteal [[bone]] formation may result in increased [[bone density]] of an entire phalanx resulting in so called ivory phalanx.
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| ** Pencil-in-cup deformity (osteolytic lesions) usually involving [[Interphalangeal articulations of hand|DIP joints]] but also affects [[Interphalangeal articulations of hand|PIP joints]]
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| ** [[Osteolysis]] and [[ankylosis]] both coexists in the same [[Joint|joints]] of [[Hand|hands]] and [[foot]]
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| ** [[Enthesopathy|Enthesitis]]
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| ** [[Dactylitis]] (sausage digit)
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| ** Gross finger [[deformity]]
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| ** [[Arthritis]] mutilans: It may lead to "telescoping of fingers" caused by marked bony resorption and the subsequent collapse of soft tissue
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| ** Asymmetrical [[sacroiliitis]]
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| ** [[Spondylitis]]: Asymmetric paravertebral ossifications and relative sparing of the facet joints
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| [[File:Psoriatic-arthritis of hands.jpg|centre|thumb|Psoriatic-arthritis of hands showing pencil-in-cup deformity - By Case courtesy of Dr Jeremy Jones, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/8798">rID: 8798</a>]]
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| *MRI:
| | ==[[Psoriatic arthritis pathophysiology|Pathophysiology]]== |
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| === Other Diagnostic Studies === | | ==[[Psoriatic arthritis causes|Causes]]== |
| * [[Bone mineral density]] (BMD) testing: [[Bone density]] may decreased in psoriatic arthritis resulting in [[osteoporosis]] and increased risk for [[Bone fracture|fractures]]. <ref name="pmid11196516">{{cite journal |vauthors=Frediani B, Allegri A, Falsetti P, Storri L, Bisogno S, Baldi F, Filipponi P, Marcolongo R |title=Bone mineral density in patients with psoriatic arthritis |journal=J. Rheumatol. |volume=28 |issue=1 |pages=138–43 |date=January 2001 |pmid=11196516 |doi= |url=}}</ref>
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| == Treatment == | | ==[[Psoriatic arthritis differential diagnosis|Differentiating Psoriatic arthritis from Other Diseases]]== |
| === Medical Therapy ===
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| *There is no treatment for [disease name]; the mainstay of therapy is supportive care.
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| *The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
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| *[Medical therapy 1] acts by [mechanism of action 1].
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| *Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].
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| === Surgery ===
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| *Surgery is the mainstay of therapy for [disease name].
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| *[Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
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| *[Surgical procedure] can only be performed for patients with [disease stage] [disease name].
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| === Prevention ===
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| *There are no primary preventive measures available for [disease name].
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| *Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
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| *Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].
| | ==[[Psoriatic arthritis epidemiology and demographics|Epidemiology and Demographics]]== |
| ==References==
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| {{Reflist|2}}
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| [[Category:Pick One of 28 Approved]]
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| | ==[[Psoriatic arthritis risk factors|Risk Factors]]== |
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| | ==[[Psoriatic arthritis screening|Screening]]== |
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| | ==[[Psoriatic arthritis natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
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| | ==Diagnosis== |
| | [[Psoriatic arthritis diagnostic study of choice |Diagnostic study of choice]] | [[Psoriatic arthritis history and symptoms|History and Symptoms]] | [[Psoriatic arthritis physical examination|Physical Examination]] | [[Psoriatic arthritis laboratory tests|Laboratory Findings]] | [[Psoriatic arthritis electrocardiogram|Electrocardiogram]] | [[Rheumatoid arthritis x ray|X ray]] | [[Rheumatoid arthritis echocardiography and ultrasound|Echocardiography and Ultrasound]] | [[Psoriatic arthritis CT|CT]] | [[Psoriatic arthritis MRI|MRI Findings]] | [[Psoriatic arthritis other imaging findings|Other Imaging Findings]] | [[Psoriatic arthritis other diagnostic studies|Other Diagnostic Studies]] |
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| | ==Treatment== |
| | [[Psoriatic arthritis medical therapy|Medical Therapy]] | [[Psoriatic arthritis surgical therapy|Surgical Therapy]] | [[Psoriatic arthritis Primary prevention|Primary prevention]] | [[Psoriatic arthritis secondary prevention|Secondary prevention]] | [[Psoriatic arthritis future or investigational therapies|Future or Investigational Therapies]] |
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| | ==Case Studies== |
| | :[[Psoriatic arthritis case study 1|Case #1]] |
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| | ==Related Chapters== |
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| | {{Diseases of the musculoskeletal system and connective tissue}} |
| | {{WH}} |
| {{WS}} | | {{WS}} |
| {{WH}}
| | e)|adverse effects]] and associated [[Comorbidity|comorbid conditions]]. |
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| | [[Category:Arthritis]] |
| | [[Category:Autoimmune diseases]] |
| | [[Category:Rheumatology]] |