title: [Diagnosis and course of early arthritis; study in a specialized clinic for early arthritis].
abstract: OBJECTIVE
  To investigate the occurrence, diagnosis and course of all new inflammatory arthropathies seen in a special Early Arthritis Clinic (EAC).
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Academic Medical Hospital, Leiden, The Netherlands.
  
  
  METHODS
  An Early Arthritis Clinic (EAC) was started in the outpatient clinic of rheumatology of Leiden University Hospital for diagnostic work-up according to protocol of patients with recent-onset arthritis. Inclusion criteria were: active arthritis with onset < 2 years without traumatic aetiology and no referral for a second opinion.
  
  
  RESULTS
  In the first 18 months 276 patients were sent to the EAC, 212 met the inclusion criteria. After 2 weeks the following diagnoses were made: rheumatoid arthritis (RA) (58; 28%), psoriatic arthritis (8; 4%), reactive arthritis (11; 5%) sarcoidosis (9; 4%), crystal arthritis (30; 14%), osteoarthritis (8; 4%), other diagnosis (18; 8%). The remaining 70 patients (33%) were classified as arthritis e causa ignota (e.c.i.). After follow-up, the first diagnoses changed in 27 (12%) patients, of whom 20 patients originally had had the diagnosis of arthritis e.c.i. Persistent arthritis was found in 90% of RA and in 35% of arthritis e.c.i. Other forms of arthritis seldom showed persistent activity.
  
  
  CONCLUSIONS
  In the EAC, RA, arthritis e.c.i. and crystal arthritis were seen most often. Almost all RA patients showed persistent arthritis, as against only a third of those with arthritis e.c.i. Because of the early diagnosis treatment could start early in patients with joint disease entailing irreversible joint destruction.
authors.affiliation: Academisch Ziekenhuis, afd. Reumatologie, Leiden.
authors.forename: I
authors.initials: I
authors.lastname: Speyer
authors.forename: I E
authors.initials: IE
authors.lastname: van der Horst-Bruinsma
authors.forename: F C
authors.initials: FC
authors.lastname: Breedveld
authors.forename: J M
authors.initials: JM
authors.lastname: Hazes
mesh_terms: D001168:Arthritis / Q000175:diagnosis* / Q000453:epidemiology; D015331:Cohort Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010044:Outpatient Clinics, Hospital; D011446:Prospective Studies
vernacular_title: Diagnose en verloop van vroege artritis; onderzoek op een gespecialiseerde polikliniek voor vroege artritis.