31st January 2024

A 35-year-old female with a known history of rheumatoid arthritis on methotrexate is followed up by her GP.

A 35-year-old female with a known history of rheumatoid arthritis on methotrexate is followed up by her GP. She reports over the past 4 months that her symptoms of RA are worse. She has morning pain and stiffness in most of her joints, which lasts throughout the day. She hasn’t noticed any swelling. On review, there is no deformity identified, although she has tenderness around her neck, elbows, shoulders and thighs. Inflammatory markers are normal, and an ultrasound revealed no active synovitis. On further questioning, she reports fatigue, poor concentration and low mood. A diagnosis of fibromyalgia is considered. 

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