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The British Journal of Rheumatology, Vol 37, 1084-1088, Copyright © 1998 by British Society for Rheumatology


ORIGINAL PAPERS

Diagnosis and course of early-onset arthritis: results of a special early arthritis clinic compared to routine patient care

IE van der Horst-Bruinsma, I Speyer, H Visser, FC Breedveld and JM Hazes
Department of Rheumatology, Leiden University Hospital, The Netherlands.

OBJECTIVE: Early arthritis patients referred to an Early Arthritis Clinic (EAC) (n = 233) were compared to 241 patients from the routine out-patient clinic with respect to lag time between the onset of symptoms and the visit to the rheumatologist, clinical presentation and the consistency of the diagnosis after 1 yr. RESULTS: The reduction in median lag time for the EAC patients was at least 3 months. An insidious onset of symptoms was found more often in the rheumatoid arthritis (RA) patients in the routine clinic. In 70% of all cases, a diagnosis could be made after 2 weeks and, if the clinical diagnosis was definite RA, this hardly changed during the following year. Early erosions were seen in 25% of RA patients and were associated with a positive rheumatoid factor (OR 2.08, 95% CI 0.95 4.59). CONCLUSION: An early diagnosis of RA at the EAC is possible and reliable; the high frequency of erosions illustrates the need for early treatment.
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