Symptoms of RA, in the early stages, can overlap with other diseases. This can delay specialist referrals and the timely diagnosis of RA.
Early RA Diagnosis and Appropriate Treatment Improves Clinical Outcomes
The symptoms of early rheumatoid arthritis can overlap with those of several other diseases such as osteoarthritis, gout, fibromyalgia and autoimmune conditions such as systemic lupus erythematosus (lupus) as well as joint inflammation due to infections.
This overlap of symptoms is one of the contributors to delayed primary care referrals of RA patients to rheumatologists, who can make the diagnosis. The American College of Rheumatology has recently changed RA classification criteria to capture more early RA patients since clinical data strongly indicates that early diagnosis within 6-12 weeks of symptom onset and appropriate treatment can dramatically change the course of the disease. Criteria that are used for RA classification include:
- Morning stiffness of the joints for at least one hour.
- Swelling around three or more joints.
- One or more swollen areas in the wrist, hand, or finger joints.
- Arthritis involving the same joint on both sides of the body.
- Abnormal arthritis blood tests.
- Symptom duration of at least 6 weeks
Symptoms are usually persistent but can be sporadic. Patients often live with their symptoms for a long time before seeking care because they think their joint pain is due to “over use” or normal aches and pains. This, taken together with primary care challenges in differentiating RA symptoms contributes to delayed diagnosis. The average time between symptom onset and an RA diagnosis is approximately 9 months.
JOINTstat™ is a new diagnostic blood test for RA that can help transform the management of the disease by helping identify more patients earlier, so that they can be promptly referred to a rheumatologist for treatment, to minimize joint damage progression and disease activity.