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©2013 UpToDate ® Print Email Assessment of disease activity in rheumatoid arthritis Symptoms Duration of morning stiffness Pain score (visual analogue scale) Fatigue - severity (visual analogue scale) Patient's global score of disease activity (visual analogue scale) Physical examination Number of swollen joints Number of tender joints Degree of swelling and/or tenderness Extra-articular disease: Minor nodules, episclertis, pure sensory neuropathy, pleruropericardial disease Major vasculitis, Felty's syndrome, motor neuropathy, interstitial lung disease Laboratory Elevated erythrocyte sedimentation rate Increased C-reactive protein Anemia (in the absence of chronic blood loss or hematuria) Leukocytosis Thrombocytosis Abnormal liver function tests (low albumin, raised alkaline phosphate) in the absence of drug toxicity or liver disease Inflammatory joint fluid (high polymorph count, low complement, fibrin) Imaging Low bone mineral density (juxta-articular, vertebrae, pelvis) in absence of glucocorticoid therapy or known cause