Background There is a paucity of data regarding the case mix in Rheumatology new patient clinics in the United Kingdom. In addition, the prevalence of inflammatory rheumatic diseases is known to vary between countries and, indeed, geographical variations have been shown within the same country [ref]. Northumbria Healthcare NHS Foundation Trust is one of the largest geographical trusts in the UK with a large rural/suburban population. We sought to identify whether there are differences in the case mix in the rural/urban areas of the trust and compare our patient population to the rest of UK
Methods Five consultant rheumatologists retrospectively recorded the diagnoses of at least fifty of their most recent new patients in the preceding two months (n=256), after the results of preliminary investigations were available. The patients with inflammatory arthritis were sub classified into seropostive(RA +) and sero negative(RA -) rheumatoid arthritis, Psoriatic arthritis (PsA) and other Spondyloarthritides We estimated the incidence of RA + and RA - for the 570,000 population that the trust serves
Results Inflammatory arthritis accounts for more than one third (37%) of the new patients seen within our trust.
Other Rheumatological include osteoporosis, Vitamin D deficiency, primary Raynaud’s, PMR, GCA, HSP, CRPS, JIA and Fibromyalgia
The annual incidence of RA (RA+ and RA-) in our population is 44/100,000. However on separating the RA+ from RA- the annual incidence of RA+ is 19/100,000.Our estimated incidence of PsA is 44/100,000 and that of other Spondyloarthritis including Ankylosing spondylitis is 11.4/100,000.
The annual incidence of RA+ in rural and suburban populations was 6/100,000 and 13/100,000 respectively.
Conclusions There is a high incidence of IA in Northumberland with a higher proportion of patients having PsA or IA-. Our estimated annual incidence of RA is different from The Norfolk data of 26/100000. We have identified differences in incidence between rural/urban areas, which may be indicative of wider geographical variations in incidence of RA or Reflect referral patterns from GP’s. It would be interesting to compare our figures with other centres. Our study has certain limitations being small and we have extrapolated the data over two months for calculating the annual incidence, but does highlight a potential area of further research: the potential geographical variation in the incidence of RA throughout the UK.
Disclosure of Interest None Declared
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