AB0378 Osteoarthritis is the Most Frequent Cause of Rheumathoid Arthritis Misdiagnosis in a Colombian Specialized Center

Abstract

BackgroundFrequently, patients with osteoarthritis (OA) are misdiagnosed as rheumatoid arthritis (RA) in primary care centers, leading to wrong treatment and consequent clinical and health economics impact.ObjectivesThe objective of this study was to describe demographic and clinical characteristics of a cohort of patients derived to a specialized RA center with presumptive RA diagnosis and finally diagnosed as osteoarthritis.MethodsA descriptive cross sectional study. Patients were referred and assisted to a specialized RA center in a 36 month period with presumptive diagnosis of rheumatoid arthritis. Each patient was evaluated to confirm or rule-out diagnosis of RA as follows: a rheumatologist fulfilled a complete medical record, including joint counts; it was assessed rheumatoid factor and anti-citrullinated antibodies, and other laboratories depending on each case. Also were made x-rays of hands and feet, and in some cases of persistent doubt about the diagnosis was requested comparative MRI of hands or/and feet. Frequencies and percentages were calculated for the demographic and clinical characteristics of the cohort of patients in which the diagnosis of RA was ruled-out.ResultsFrom a total of 4780 Patients derived to specialized in RA center with presumptive RA diagnosis, after medical and laboratory evaluation 1875 (39.3%) had a wrong RA diagnosis; of them 1108 patients (59.1%) had finally osteoarthritis diagnosis. Of these patients 783 (70.6%) were women and 325 (29.3%) men, with an average age of 57.4 (±12 years). Majority of these patients were followed by general physicians or internists and treated with non-biologic and biologic disease modifying anti-rheumatic drugs (DMARDs) in the past years, for an average time of 4.5 years.ConclusionsIn this cohort of patients the most frequent diagnosis of patients misdiagnosed with RA was osteoarthritis, being more than two thirds of them, predominantly women. This shows the need for the implementation of specialized clinics in RA and educational strategies for primary care physicians in order to avoid the impact of this wrong diagnosis.Disclosure of InterestNone declared

Effect of Crocus sativus (Saffron) Intake on Top of Standard Treatment, on Disease Outcomes and Comorbidities in Patients with Rheumatic Diseases: Synthesis without Meta-Analysis (SWiM) and Level of Adherence to the CONSORT Statement for Randomized Controlled Trials Delivering Herbal Medicine Interventions

“…Although not belonging to the RDs, osteoarthritis (OA) was also included in the search strategy, since many patients with RA are often misdiagnosed with OA and vice versa [22].…”

“…Studies were included in the synthesis when they (1) had an RCT design, (2) were parallel or cross-over, (3) used an active per os intervention with saffron in any form (tabs, caps, powder, syrup, sachets, tea), (4) were conducted in patients with a RD diagnosis (or osteoarthritis), (5) examined any age group, and (6) used a placebo or any other intervention as a comparator (comparative effectiveness studies). Although not belonging to the RDs, osteoarthritis (OA) was also included in the search strategy, since many patients with RA are often misdiagnosed with OA and vice versa [22].…”

“…In the present SWiM, RCTs performed in patients with an OA diagnosis were also included, as often, patients with RA are misdiagnosed with OA, and vice versa [22]. Thus, it is possible that some of the patients included in the trials might have belonged in the opposite diagnosis, despite recruitment intentions.…”