期刊
RHEUMATOLOGY
卷 53, 期 9, 页码 1646-1653出版社
OXFORD UNIV PRESS
DOI: 10.1093/rheumatology/keu159
关键词
symptom complex; arthralgia; rheumatoid arthritis; qualitative; early arthritis; symptom experience
类别
资金
- Arthritis Research UK
- National Institute for Health Research
- Dutch Arthritis Association
- MRC [MR/K00414X/1] Funding Source: UKRI
- Medical Research Council [MR/K00414X/1] Funding Source: researchfish
- Versus Arthritis [19634] Funding Source: researchfish
Objective. The aim of this study was to explore symptoms and symptom development during the earliest phases of RA in patients with seropositive arthralgia and patients newly diagnosed with RA. Methods. Interviews were conducted with 15 seropositive patients (anti-CCP positive, and often with arthralgia) and 11 newly presenting RA patients [classified according to the 2010 ACR/European League Against Rheumatism (EULAR) criteria]. Feedback procedures shared the experiences of seropositive arthralgia patients with early RA patients and vice versa. Data were analysed using thematic analysis. Results. Symptoms common to both groups included joint pain, psychological distress, muscle cramps, abnormal skin sensations, stiffness, loss of motor control, weakness, fatigue and sleeping difficulties. Also, patterns of symptom evolution and the order of symptom development were described. Seropositive arthralgia patients described pain as annoying, while RA patients described how the severity of pain intensified before diagnosis, to the point where symptoms were psychologically distressing. Patients with seropositive arthralgia described reddening of the skin and burning sensations that they felt were indicative of the onset of swelling. Intense pain appeared to precede the onset of swelling for those with RA, which was often palindromic and travelled between joints until it later became persistent. Conclusion. This study highlights the breadth of symptoms that constitute the earliest phases of RA. Further research is needed to develop measures of symptom patterns and clusters to allow the predictive utility of symptoms to be assessed and to allow the integration of aspects of the patient's history into evidence-based investigative and management algorithms for use in primary and secondary care.
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