900 patients evaluated within a median of 1 day from referral in a very early arthritis clinic in France.

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.