Consultation rates for symptoms related to inflammatory arthritis increase prior to diagnosis
Consultations for musculoskeletal symptoms and infections increase prior to an inflammatory arthritis diagnosis.
Consultation rates in general practice for symptoms related to inflammatory arthritis increase a few years prior to the diagnosis, researchers reported at the 2016 American College of Rheumatology/Association of Rheumatology Health Professionals Annual Meeting. The symptoms could be useful to develop methods of earlier detection of inflammatory arthritis.
Marian vans Beers-Tas, MD, from the Amsterdam Rheumatology & Immunology Center in the Netherlands, and colleagues conducted a nested case-control study using data from electronic medical records to measure the number and timing of visits to general practitioners for 192 symptoms and diseases up to 9 years before a diagnosis of inflammatory arthritis.
The study included medical records from 2,772 patients who were diagnosed with inflammatory arthritis between 2012 and 2014. The researchers also included a control group matched at a 1:2 ratio for age, gender, general practice, and retrospective duration of follow-up.
Among patients diagnosed with inflammatory arthritis, the consultation rate for musculoskeletal symptoms increased in the last 1.5 years before diagnosis, with an odds ratio (OR) of 1.8 at 6 months, an OR of 1.4 at 12 months, and an OR of 1.3 at 18 months prior to the diagnosis.
The consultation rate was significantly higher for infections 6 and 18 months prior to diagnosis (OR, 1.2 for both). The rates for diseases related to inflammatory arthritis and other chronic diseases significantly increased 3 months before diagnosis (OR, 1.2; OR, 1.3, respectively).
Patients who were diagnosed with inflammatory arthritis had higher rates of shoulder complaints compared with controls (16.1% vs 5.6%). Patients diagnosed with inflammatory arthritis also had higher rates of hand or finger complaints (12.2% vs 5.6%), carpal tunnel syndrome (5% vs 2.5%) and foot or toe complaints (15.2% vs 9.2%).
The researchers note that the increased consultation rates for musculoskeletal symptoms and infectious diseases began 4 to 6 years prior to diagnosis but become statistically significant about 1.5 years before the diagnosis.
- van Beers-Tas M, Nielen M, Korevaar JC, et al. Early detection of inflammatory arthritis: The role of musculoskeletal symptoms, infections, and rheumatoid arthritis-related comorbidities in primary care. Abstract 489. Presented at the 2016 ACR/ARHP Annual Meeting; November 11-14, 2016; Washington DC.