Evolution of undifferentiated arthritis: a ten-year experience from the early arthritis clinic of a tertiary care hospital.
OBJECTIVE
Undifferentiated arthritis (UA) is an inflammatory oligo/polyarthritis where no definite diagnosis can be reached. Patients with UA may progress towards a chronic inflammatory disease, however, in some cases arthritis may completely resolve. To date, a universally accepted diagnostic and therapeutic algorithm for UA is not available.


METHODS
We retrospectively studied 192 patients with UA followed by us over the last 10 years in the early arthritis clinic of our institution.


RESULTS
A total of 192 patients, 91 men (47.4%) and 101 women (52.6%), with mean age 57.9±17.8 years, were included in the study. Eighty-four patients (43.7%) presented with acute/subacute mono-/pauci-arthritis, 56 patients (29.2%) with chronic mono-/pauci arthritis, 42 patients (21.9%) with acute polyarthritis and 10 (5.2%) with chronic polyarthritis. From the total of 192 patients, 102 are currently followed. Current diagnosis at the time of this report included: rheumatoid arthritis in 18 (17.6%) patients, self-limiting arthritis in 35 (34.4%), undifferentiated/unclassified arthritis in 45 (44.1%), spondyloarthropathy in 3 (2.9%), and crystal-induced arthritis in one (1%). The time between the initial evaluation and the definitive diagnosis of RA ranged between 6 and 15 months. Seropositivity (RF and/or ACPA) and disease duration were strong predictors of developing RA in our cohort.


CONCLUSIONS
Our data indicate that seropositive patients with chronic symptoms carry an increased risk of developing RA, and that these patients may be candidates for a more aggressive treatment.
Department of Rheumatology, University of Patras Medical School, Patras University Hospital, Patras, Greece.
Georgios
G
Yiannopoulos
Department of Rheumatology, University of Patras Medical School, Patras University Hospital, Patras, Greece.
Dimitrios
D
Daoussis
Department of Rheumatology, University of Patras Medical School, Patras University Hospital, Patras, Greece.
Konstantinos
K
Melissaropoulos
Department of Rheumatology, University of Patras Medical School, Patras University Hospital, Patras, Greece.
Christina
C
Tsouni
Department of Rheumatology, University of Patras Medical School, Patras University Hospital, Patras, Greece.
Andrew P
AP
Andonopoulos
D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001168:Arthritis / Q000097:blood / Q000145:classification / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D018450:Disease Progression; D005260:Female; D006115:Greece; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012698:Serologic Tests; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome
D018501:Antirheumatic Agents; D015415:Biomarkers