Diagnosis is confirmed by X-ray and a blood test that can identify a "rheumatoid factor." Conventional treatment focuses on reducing inflammation with nonsteroidal anti-inflammatory drugs and penicillamine or sulfasalazine injections. Failing these, immunosuppressant drugs such as steroids or azathioprine will retard the autoimmune response. Physiotherapy can relieve muscle spasms and stiffness, and splints help to reduce pain in the hands and wrists. Replacement surgery may be necessary if a joint has been damaged.
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