Symptoms associated with inflammatory arthritis are common in the primary care population: results from the joint symptoms survey

Rheumatology (Oxford). 2019 Nov 1;58(11):2009-2014. doi: 10.1093/rheumatology/kez184.

Abstract

Objectives: To describe the prevalence of self-reported inflammatory joint symptoms, such as joint pain, stiffness and swelling, in UK primary care patients consulting for both musculoskeletal (MSK) and non-musculoskeletal (non-MSK) complaints.

Methods: A joint symptoms questionnaire survey was sent to 10 161 individuals, of whom 5050 had consulted for MSK problems. These were matched by age, gender and general practice to non-MSK consulters. Participants provided data on relevant symptoms such as joint pain, stiffness and swelling. The prevalence of these symptoms, their severity and impact were compared between MSK and non-MSK consulters.

Results: A total of 4549 adults responded to the survey (adjusted response 45.8%) of whom 52.3% consulted for a MSK problem. The mean (s.d.) age was 61.6 (14.8) years and 58.9% were female. Persistent (on at least half of the days in the last month) inflammatory symptoms were common even in non-MSK consulters, with 42% reporting joint pain, 36% reporting joint stiffness and 18% reporting joint swelling. This is in comparison with 62% reporting joint pain, 50% stiffness and 24% swelling among MSK consulters.

Conclusions: Although symptoms such as persistent joint pain, swelling and stiffness are predictive of inflammatory arthritis, large numbers of people consulting primary care for non-MSK reasons report these symptoms when asked by questionnaire. This compounds the challenges of diagnosing inflammatory arthritis in a non-specialist setting where new approaches are needed to ensure accurate, early diagnosis, facilitating a treat-to-target approach.

Keywords: inflammatory arthritis; joint pain; joint swelling; primary care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Arthralgia / diagnosis*
  • Arthralgia / epidemiology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Joint Diseases / diagnosis*
  • Joint Diseases / epidemiology
  • Male
  • Middle Aged
  • Musculoskeletal Diseases / diagnosis*
  • Musculoskeletal Diseases / epidemiology
  • Prevalence
  • Primary Health Care / statistics & numerical data*
  • Referral and Consultation / statistics & numerical data
  • Surveys and Questionnaires
  • Symptom Assessment / statistics & numerical data*
  • United Kingdom / epidemiology