Background There is a lack of expertise in the rheumatoid arthritis (RA) diagnosis in primary level medical centers in Colombia. Frequently, patients with osteoarthritis (OA) are misdiagnosed as rheumatoid arthritis (RA) in primary care centers, leading to wrong treatment and consequent clinical and pharmacoeconomic impact.
Objectives The objective of this study was to describe demographic and clinical characteristics of a cohort of patients derived to a specialized RA center with presumptive RA diagnosis and finally diagnosed as osteoarthritis.
Methods A descriptive, cross sectional study. Patients were referred and assisted to a specialized RA center in a 24 month period with presumptive diagnosis of this disease. A complete medical record was fulfilled by a rheumatologist; it was measured rheumatoid factor and anti-citrullinated antibodies, and other laboratories depending on each case. Also were made x-rays of hands, and in some cases of persistent doubt about the diagnosis was requested comparative MRI of hands. Frequencies and Percentages were calculated for the demographic and clinical characteristics of the cohort of patients.
Results From a total of 3665 Patients derived to specialized in RA center with presumptive RA diagnosis, after medical and laboratory evaluation 1451 (39.6%) had a wrong RA diagnosis; of them 1116 patients (76.9%) had finally osteoarthritis diagnosis. Of these patients 790 (70.7%) were women and 326 (29.2%) men, with an average age of 59.7 (±12 years). Majority of these patients were followed by general physicians or internists and treated with non-biologic and biologic disease modifying anti-rheumatic drugs (DMARDs) in the past, for an average time of 4.5 years.
Conclusions In this cohort of patients the most frequent diagnosis of patients misdiagnosed with RA was osteoarthritis, being more than two thirds of them, predominantly women. This shows the need for the implementation of specialized clinics in RA and educational strategies for primary care physicians in order to avoid the impact of this wrong diagnosis.
Disclosure of Interest None declared
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