Diagnosis and course of early-onset arthritis: results of a special early arthritis clinic compared to routine patient care.
OBJECTIVE
Early arthritis patients referred to an Early Arthritis Clinic (EAC) (n = 233) were compared to 241 patients from the routine out-patient clinic with respect to lag time between the onset of symptoms and the visit to the rheumatologist, clinical presentation and the consistency of the diagnosis after 1 yr.


RESULTS
The reduction in median lag time for the EAC patients was at least 3 months. An insidious onset of symptoms was found more often in the rheumatoid arthritis (RA) patients in the routine clinic. In 70% of all cases, a diagnosis could be made after 2 weeks and, if the clinical diagnosis was definite RA, this hardly changed during the following year. Early erosions were seen in 25% of RA patients and were associated with a positive rheumatoid factor (OR 2.08, 95% CI 0.95 4.59).


CONCLUSIONS
An early diagnosis of RA at the EAC is possible and reliable; the high frequency of erosions illustrates the need for early treatment.
van der Horst-Bruinsma
I E
IE
Department of Rheumatology, Leiden University Hospital, The Netherlands.
Speyer
I
I
Visser
H
H
Breedveld
F C
FC
Hazes
J M
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010044:Outpatient Clinics, Hospital; D010346:Patient Care Management / Q000379:methods*