Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK.
Haywood Academic Rheumatology Centre, Midlands Partnership Foundation Trust, Stoke-on-Trent, UK.
Rheumatology (Oxford). 2019 Nov 1;58(11):2009-2014. doi: 10.1093/rheumatology/kez184.
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.
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.
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.
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.
描述在英国初级保健患者中,报告有炎性关节症状(如关节疼痛、僵硬和肿胀)的患者比例,这些患者同时存在肌肉骨骼(MSK)和非肌肉骨骼(非 MSK)问题。
对 10161 名患者进行了关节症状调查问卷调查,其中 5050 名患者因 MSK 问题就诊。这些患者按照年龄、性别和全科医生与非 MSK 就诊者相匹配。参与者提供了与关节疼痛、僵硬和肿胀等相关症状的数据。比较了 MSK 和非 MSK 就诊者之间这些症状的患病率、严重程度和影响。
共有 4549 名成年人对调查做出了回应(调整后的回应率为 45.8%),其中 52.3%因 MSK 问题就诊。平均(标准差)年龄为 61.6(14.8)岁,58.9%为女性。即使在非 MSK 就诊者中,持续性(至少在过去一个月的一半以上天数存在)炎性症状也很常见,42%报告关节疼痛,36%报告关节僵硬,18%报告关节肿胀。相比之下,62%的 MSK 就诊者报告关节疼痛,50%的就诊者报告关节僵硬,24%的就诊者报告关节肿胀。
尽管持续性关节疼痛、肿胀和僵硬等症状是炎症性关节炎的预测因素,但大量因非 MSK 原因就诊初级保健的患者在被问到问卷时会报告这些症状。这增加了在非专科环境中诊断炎症性关节炎的挑战,需要新的方法来确保准确、早期的诊断,从而实现治疗目标。