Follow up SSS

OVERVIEW: - Follow-up visit for established patient with rheumatoid arthritis. - Patient reports improvement in symptoms since last visit. NOTABLE COMORBIDITIES: - Rheumatoid arthritis diagnosed 2018. - Hypertension. PRIOR PERTINENT MEDICATIONS: - Methotrexate 15mg weekly (discontinued due to nausea). CURRENT PERTINENT MEDICATIONS: - Adalimumab 40mg subcutaneous injection every other week. - Prednisone 5mg daily. - Lisinopril 10mg daily. INTERVAL HISTORY: - Patient reports significant improvement in joint pain and stiffness since starting adalimumab. - Morning stiffness now lasts for approximately 30 minutes, compared to 2 hours previously. - No new joint involvement reported. - No fevers, rashes, or other systemic symptoms. RELEVANT FAMILY HISTORY: - Mother with rheumatoid arthritis. RELEVANT SOCIAL HISTORY: - Works as a teacher. - Non-smoker. - Drinks alcohol occasionally. - Lives with spouse. - Exercises regularly. PHYSICAL EXAMINATION: - No active synovitis in any joints. - Mild tenderness in the bilateral wrists. - No other significant findings. PERTINENT LABS: - ESR (1 November 2024): *25* (decreased from 45). - CRP (1 November 2024): *1.5* (decreased from 3.0). PERTINENT DIAGNOSTICS: - None. ASSESSMENT: #RHEUMATOID ARTHRITIS: Patient doing well on current treatment. - Rheumatoid arthritis well-controlled with adalimumab and prednisone. - No evidence of disease flares. - Differential diagnosis: Rheumatoid arthritis, osteoarthritis. PLAN: - Continue adalimumab 40mg subcutaneous injection every other week. - Continue prednisone 5mg daily. - Monitor ESR and CRP every 3 months. - Discussed potential side effects of adalimumab. - Reviewed importance of vaccinations. - Follow-up in 3 months. FOLLOW UP: - Follow up in 3 months. INSTRUCTIONS: - Continue current medications as prescribed. - Report any new symptoms or side effects. - Schedule follow-up appointment in 3 months.