Rheumatology advances in practice · 2026
900 patients evaluated within a median of 1 day from referral in a very early arthritis clinic in France.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
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Ebstein Esther, Juge Pierre-Antoine, Forien Marine, Benattar Leslie, Péan de Ponfilly Marie, Franc Madeleine, Léger Bastien, Dupont Anne, Lemee Manon, Jessen Chloé, Moret Margaux, Bastard Léa, Carré Laurinda, Mahjoub Sirine, Klimek Monika, Molto Anna, Gallais Marie-Christine, Dousset Mylène, Ottaviani Sébastien, Dieudé Philippe
Аннотация
OBJECTIVE: In order to fit with National Institute for Health and Care Excellence (NICE) guidelines on arthritis, we established a 'very early arthritis clinic' (v-EAC) to evaluate patients within 48 h of a medical referral for any suspected arthritis of <1-month duration. We describe the characteristics of patients referred to the v-EAC from 2 October 2023 to 1 October 2024.
METHODS: Delay of referral was recorded. A systematic and standardized clinical, biological and ultrasound evaluation of all consecutive patients was conducted. Patients and disease characteristics are described.
RESULTS: A total of 900 patients were evaluated within a median delay of 1 day after referral: 51% were women and the median age was 55 years (IQR 42-67). Among these patients, 37% were referred by emergency departments, 28% by rheumatologists, 18% by general practitioners and 17% by other specialists. For 46% of patients, it was the first episode of a swollen joint, with a median symptom duration of 14 days (IQR 5-44) and a mean number of 1.3 (s.d. 1.9) swollen joints. Inflammatory arthritis was confirmed in 63% of cases and diagnoses were flare of immune-mediated inflammatory disease (IMID)-related arthritis in 35% of cases (half of which represented the first manifestation of an IMID-related arthritis), crystal-related arthritis in 27% (mostly gout) and infectious disease in 8.0% (including 34 bursitis and 13 septic arthritis). Joint aspiration was performed in 414 patients (46%). Corticosteroid-derivative injections were administered to 31% of patients and hospitalization was required in 10% of cases [median stay 6 days (IQR 4-8)].
CONCLUSION: A dedicated care pathway can make the NICE guidelines regarding management of arthritis reachable.
METHODS: Delay of referral was recorded. A systematic and standardized clinical, biological and ultrasound evaluation of all consecutive patients was conducted. Patients and disease characteristics are described.
RESULTS: A total of 900 patients were evaluated within a median delay of 1 day after referral: 51% were women and the median age was 55 years (IQR 42-67). Among these patients, 37% were referred by emergency departments, 28% by rheumatologists, 18% by general practitioners and 17% by other specialists. For 46% of patients, it was the first episode of a swollen joint, with a median symptom duration of 14 days (IQR 5-44) and a mean number of 1.3 (s.d. 1.9) swollen joints. Inflammatory arthritis was confirmed in 63% of cases and diagnoses were flare of immune-mediated inflammatory disease (IMID)-related arthritis in 35% of cases (half of which represented the first manifestation of an IMID-related arthritis), crystal-related arthritis in 27% (mostly gout) and infectious disease in 8.0% (including 34 bursitis and 13 septic arthritis). Joint aspiration was performed in 414 patients (46%). Corticosteroid-derivative injections were administered to 31% of patients and hospitalization was required in 10% of cases [median stay 6 days (IQR 4-8)].
CONCLUSION: A dedicated care pathway can make the NICE guidelines regarding management of arthritis reachable.