Abstract

The development of Rheumatoid Arthritis (RA) consists of different phases, including the phase of arthralgia without clinically apparent arthritis. In contrast to the other phases that have been studied extensively already, the preclinical phase of symptoms without clinically apparent arthritis is studied scarcely. The symptoms that are specific for a preclinical phase of RA are not yet characterized, which hampers the conduct of intervention trials in patient with symptoms of RA but no clinically apparent arthritis. The chronicity of RA is currently considered an unmet meet and in the nearby feature several trials will evaluate whether intervention in the preclinical symptomatic phase of RA is effective in preventing “chronification” of arthritis. This indicates the need to better characterise the symptoms that are specific for a preclinical phase of RA.

The clinical expertise is a valuable tool to delineate a subgroup of arthralgia patients with an increased risk on RA. Here I will present two patients with clinically suspect arthralgia and show their disease course. In addition, the ongoing work of an EULAR taskforce that aims to develop criteria for clinically suspect arthralgia (CSA) based on methodology that uses the aggregated expert opinion as external standard will be briefly presented.