Background
Methods
Participants
US | Non-US | RA US | RA Non-US | |
---|---|---|---|---|
Total no. Patients | 134 | 124 | 56 | 58 |
Mean (standard deviation) age (years) at initial clinic visit | 51.28 (15.75) | 53.12 (17.34) | 54.42 (17.21) | 54.19 (17.75) |
N (%)Male | 42 (31%) | 43 (35%) | 17 (30%) | 14 (24%) |
N (%) Female | 92 (69%) | 81 (65%) | 39 (70%) | 44 (76%) |
Median (IQR) time (months) from onset of symptoms to first clinic visit | 5.98 (3.66 to 14.26) | 5.26 (2.89 to 7.62) | 5.36 (3.61 to 12.87) | 4.78 (3 to 10.56) |
Tests carried out prior to initial clinic visit by referring GPa
| ||||
N (%) Rheumatoid Factor | 82 (61%) | 81 (65%) | 42 (75%) | 45 (78%) |
N (%) Anti-CCP | 8 (6%) | 9 (7%) | 4 (7%) | 6 (10%) |
N (%) CRP | 90 (67%) | 78 (63%) | 42 (75%) | 36 (62%) |
N (%) ESR | 92 (69%) | 84 (68%) | 40 (71%) | 41 (71%) |
N (%) FBC | 98 (73%) | 74 (60%) | 41 (73%) | 40 (69%) |
N (%) Joint x-ray (any joint) | 39 (29%) | 37 (30%) | 17 (30%) | 18 (31%) |
ANA | 51 (38%) | 54 (44%) | 26 (46%) | 28 (48%) |
Otherb
| 67 (50%) | 60 (48%) | 27 (48%) | 28 (48%) |
Ethical approval
Data collection
Statistical analysis
Results
Diagnosis | US | Non-US |
---|---|---|
Rheumatoid arthritis | 56 | 58 |
Primary inflammatory arthritis (other than RA) | 27 | 23 |
Mechanical or degenerative disorder | 24 | 21 |
Connective tissue disease | 4 | 3 |
Other systemic inflammatory disorder | 2 | 4 |
Crystal arthritis | 3 | 3 |
Metabolic disorder | 2 | 3 |
Pain syndrome | 4 | 2 |
Drug reaction | 1 | 0 |
Not specified / unknown | 11 | 7 |
Total | 134 | 124 |
All patients – US managed vs non-US managed groups
Time (months) to formal diagnosis | Time (months) to treatment initiation with DMARDS | |||||||
---|---|---|---|---|---|---|---|---|
US | Non-US | RA US | RA Non-US | US | Non-US | RA US | RA Non-US | |
Total | 123 | 117 | 56 | 58 | 73 | 77 | 56 | 58 |
Mean | 2.18 | 2.76 | 1.18 | 1.94 | 1.49 | 2.29 | 1.10 | 2.38 |
Median | 0.85 | 2.00 | 0.23 | 1.38 | 0.62 | 1.41 | 0.46 | 1.81 |
SD | 3.02 | 2.74 | 2.09 | 1.90 | 2.31 | 2.44 | 1.65 | 2.34 |
IQR | 0.0 to 3.22 | 0.49 to 4.14 | 0.0 to 1.25 | 0.46 to 3.15 | 0.0 to 1.74 | 0.46 to 3.25 | 0.0 to 1.38 | 0.51 to 3.42 |
P value (Mann-Whitney U) | 0.0046 | 0.0016 | 0.0048 | 0.0007 |
RA diagnosed patient subgroup– US vs non-US managed groups
Physician US questionnaires
Jointa
| LEFT SIDE (n = 162) | RIGHT SIDE (n = 162) |
---|---|---|
MCP 1
| 99 (61%) | 102 (63%) |
MCP 2
| 112 (69%) | 122 (75%) |
MCP 3
| 108 (67%) | 117 (72%) |
MCP 4
| 104 (64%) | 110 (68%) |
MCP 5
| 104 (64%) | 114 (70%) |
IP
| 70 (43%) | 68 (42%) |
PIP 2
| 88 (54%) | 90 (56%) |
PIP 3
| 87 (54%) | 89 (55%) |
PIP 4
| 74 (46%) | 76 (47%) |
PIP 5
| 74 (46%) | 75 (46%) |
Wrist
| 118 (73%) | 121 (75%) |
Elbow
| 5 (3%) | 7 (4%) |
Shoulder
| 2 (1%) | 1 (1%) |
Knee
| 10 (6%) | 8 (5%) |
Ankle
| 6 (4%) | 6 (4%) |
Mid-foot
| 1 (1%) | 1 (1%) |
MTPs
| 9 (6%) | 12 (7%) |
Other
b
| 12 (7%) |
Jointa
| No. (%) joint scanned (n = 68)b
| No. (%)c with US abnormality | No. (%) ST only | No. (%) ST + PD |
---|---|---|---|---|
MCP1 L | 47 (69.1%) | 6 (12.8%) | 5 (10.6%) | 1 (2.1%) |
MCP2 L | 53 (77.9%) | 19 (35.8%) | 6 (11.3%) | 13 (24.5%) |
MCP3 L | 51 (75.0%) | 29 (56.9%) | 17 (33.3%) | 12 (23.5%) |
MCP4 L | 49 (72.1%) | 21 (42.9%) | 16 (32.7%) | 5 (10.2%) |
MCP5 L | 50 (73.5%) | 8 (16.0%) | 1 (2.0%) | 7 (14.0%) |
MCP1 R | 47 (69.1%) | 3 (6.4%) | 3 (6.4%) | 0 (0.0%) |
MCP2 R | 52 (76.5%) | 16 (30.8%) | 2 (3.8%) | 14 (26.9%) |
MCP3 R | 53 (77.9%) | 20 (37.7%) | 9 (17.0%) | 11 (20.8%) |
MCP4 R | 48 (70.6%) | 16 (33.3%) | 9 (18.8%) | 7 (14.6%) |
MCP5 R | 48 (70.6%) | 11 (22.9%) | 1 (2.1%) | 10 (20.8%) |
IP L | 31 (45.6%) | 1 (3.2%) | 0 (0.0%) | 1 (3.2%) |
PIP2 L | 40 (58.8%) | 9 (22.5%) | 2 (5.0%) | 7 (17.5%) |
PIP3 L | 39 (57.4%) | 10 (25.6%) | 4 (10.3%) | 6 (15.4%) |
PIP4 L | 37 (54.4%) | 9 (24.3%) | 3 (8.1%) | 6 (16.2%) |
PIP5 L | 36 (52.9%) | 9 (25.0%) | 3 (8.3%) | 6 (16.7%) |
IP R | 33 (48.5%) | 1 (3.0%) | 0 (0.0%) | 1 (3.0%) |
PIP2 R | 39 (57.4%) | 10 (25.6%) | 4 (10.3%) | 6 (15.4%) |
PIP3 R | 39 (57.4%) | 15 (38.5%) | 9 (23.1%) | 6 (15.4%) |
PIP4 R | 35 (51.5%) | 8 (22.9%) | 3 (8.6%) | 5 (14.3%) |
PIP5 R | 36 (52.9%) | 8 (22.2%) | 3 (8.3%) | 5 (13.9%) |
Wrist L | 52 (76.5%) | 18 (34.6%) | 3 (5.8%) | 15 (28.8%) |
Wrist R | 49 (72.1%) | 19 (38.8%) | 7 (14.3%) | 12 (24.5%) |
MTPs L | 5 (7.4%) | 5 (100.0%) | 3 (60.0%) | 2 (40.0%) |
MTPs R | 7 (10.3%) | 7 (100.0%) | 5 (71.4%) | 2 (28.6%) |