Okay, I gave it my best shot and here is what I came up with...
"Burnt out" Ra refers to someone who has suffered from RA in a severe and active form(usually considerable) time but in whom there now appears to be no measurable disease activity in their joints. In other words, the joints no longer appear to be swollen with synovitis or show signs of inflammation...although they are certainly likely to be severely damage with whole range of motion deformaties. Similarly, blood tests may or may not show signs of inflammation with the raised ESR or CRP found in active RA.
http://books.google.com/books?id=Ezmb0OcLAVcC&pg=PA10&lpg=PA10&dq=burn+out+in+rheumatoid+arthritis&source=web&ots=ZnIKio0yGK&sig=DRlAS-6vqc76N0_0M17T-vGey7g&hl=en#PPT15,M1
Now contrast that with "end stage RA"....
Despite the availability of methotrexate (MTX), other disease modifying antirheumatic drugs (DMARDs), and anticytokine therapies, approximately 30 percent of patients with rheumatoid arthritis (RA) fail to adequately respond to therapy [1] . Via a variety of mechanisms, the joint(s) of such patients may eventually be destroyed, requiring joint arthroplasty to restore function.
This stage of the disease, termed "end-stage RA," is characterized clinically by the following features:
* Pain occurring with minimal activity and at rest
* Periarticular muscle atrophy and weakness
* A significant decline in functional status resulting in disability
Radiographic evidence of articular damage (eg, severe loss of joint space and/or erosions).
The progression of disease which culminates in end-stage RA usually occurs over years to decades. The causes of joint destruction include any combination of the following:
* Refractory disease, which has failed to respond to multiple therapies
* Intolerance or development of toxicity to one or more antirheumatic therapies, thereby requiring the discontinuation of agents which may have been beneficial
* Prolonged delay in the initiation of DMARD or anticytokine therapy
* Poor compliance with the therapeutic regimen.
http://www.uptodate.com/patients/content/topic.do;jsessionid=EBB95CDA9F2DE019A23236ED9CEE5E45.1002?topicKey=~a3Cg2LtF8miXtC&selectedTitle=1~4&source=search_result
Thankyou for your time and research on this. Mine is more "burnt out" as dx by my RD. However, with the new CAD dx I kind of wonder about the end stage, but I am not quite meeting those criteria.....that I know of. More xrays and such will have to be prescibed and checked. I still have all my bloodwork to get done as well. Appt is Thursday. Today I drop off paperwork for medicaid approval since the new dx.