Symptom complexes in patients with seropositive arthralgia and in patients newly diagnosed with rheumatoid arthritis: a qualitative exploration of symptom development

Abstract

This study highlights the breadth of symptoms that constitute the earliest phases of RA. Further research is needed to develop measures of symptom patterns and clusters to allow the predictive utility of symptoms to be assessed and to allow the integration of aspects of the patient's history into evidence-based investigative and management algorithms for use in primary and secondary care.

Enriching case selection for imminent RA: the use of anti-CCP antibodies in individuals with new non-specific musculoskeletal symptoms – a cohort study

“…Another possibility would be to refine the group to be tested and referred. Hand involvement has been reported to be more common in individuals who progress to RA 6. In our cohort, symptoms involving the wrists and/or hands, the feet and the shoulders were associated with anti-CCP positivity.…”

“…Joint pain, muscle cramps, stiffness, loss of motor control and weakness are described as the first symptoms in people with RA and anti-CCP-positive arthralgia 6. The majority of people present to their general practitioners (GPs) first.…”

The therapeutic window of opportunity in rheumatoid arthritis: does it ever close?

“…Defining the earliest symptoms ‘relevant’ to RA is a hugely challenging issue 15. Patients with new onset RA present with a wide range of symptoms besides joint pain and swelling including fatigue and morning stiffness 16 17. If a patient were to present with a 9-month history of fatigue and stiffness and a 3-week history of joint pain and swelling would they be inside or outside the therapeutic window?…”

Upcoming value of gene expression analysis in rheumatology

“…Больные РА могут чувствовать боль до начала воспалительного процесса [69], однако боль может сохраняться у значительного числа больных, несмотря на подавление воспаления [70], что может означать активацию центральной сенситизации в ответ на синовиальное воспаление [71]. Это согласуется с двумя механизмами боли при РА: периферический механизм, связанный с воспалением, и центральный механизм, связанный с набором симптомов, включающих проблемы сна, хронической усталости и изменение настроения [72].…”