Article Text

Realising early recognition of arthritis in times of increased telemedicine: the value of patient-reported swollen joints
  1. Cleo Rogier1,
  2. Bastiaan T van Dijk2,
  3. Elisabeth Brouwer3,
  4. Pascal H P de Jong1,
  5. Annette H M van der Helm-van Mil1,2
  1. 1Department of Rheumatology, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
  2. 2Department of Rheumatology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
  3. 3Department of Rheumatology and Clinical Immunology, UMCG, Groningen, The Netherlands
  1. Correspondence to Dr Cleo Rogier, Rheumatology, Erasmus Medical Center, Rotterdam 3015GD, The Netherlands; c.rogier{at}erasmusmc.nl

Statistics from Altmetric.com

Early diagnosis and management of patients with inflammatory arthritis (IA) are critical to improve long-term patient outcomes. Assessment of joint swelling at joint examination is the reference of IA identification; early access clinics are constructed to promote this early recognition. Due to the COVID-19 pandemic, the face-to-face capacity of such services is severely reduced.1 This raises the concern of a major step backward after the important progress that has been made in the past 15 years.1 Telemedicine has recently become rapidly implemented. Although probably a valuable alternative in the management of established rheumatoid arthritis (RA), there is also the fear that this might cause delay in the speed of diagnosis.2 A symptom that evidently raises suspicion for IA during remote evaluation is the presence of patient-reported swelling. This symptom is also included in triage tools.3 4

The accuracy of patient-reported swelling in comparison with joint examination has been extensively evaluated in established RA. Heterogeneous results are reported; correlation coefficients were higher when patient scored their swelling on mannequins (ρ: 0.31–0.67) than when determined with questions.5 Hypothetically, the accuracy of patient-reported joint swelling for first recognition of IA is different than for flare detection in patients with established RA. To promote evidence-based care in the era of telemedicine, we determined the accuracy of patient-reported joint swelling for actual presence of IA in persons suspected of IA …

View Full Text

Supplementary materials

  • Supplementary Data

    This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.