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Clinical features of patients with hands arthralgia referred from primary care physicians to rheumatologists: A cohort study.
Figueroa-Parra, Gabriel; Castañeda-Martinez, Martha Mariana; Herrera-Sandate, Pablo; Castañeda-Martinez, Diana Daniela; Esquivel-Valerio, Jorge Antonio; Vega-Morales, David.
Afiliação
  • Figueroa-Parra G; Rheumatology Service, University Hospital "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico.
  • Castañeda-Martinez MM; Rheumatology Service, University Hospital "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico.
  • Herrera-Sandate P; Rheumatology Service, University Hospital "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico.
  • Castañeda-Martinez DD; Rheumatology Service, University Hospital "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico.
  • Esquivel-Valerio JA; Rheumatology Service, University Hospital "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico.
  • Vega-Morales D; Rheumatology Service, University Hospital "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico. Electronic address: drdavidvega@yahoo.com.mx.
Reumatol Clin (Engl Ed) ; 20(2): 67-72, 2024 Feb.
Article em En | MEDLINE | ID: mdl-38395497
ABSTRACT

PURPOSE:

Early referral of patients with suspicious of rheumatoid arthritis (RA) has an impact on prognosis. Our study aimed to evaluate the clinical characteristics of patients with hands arthralgia who were referred from primary care physicians (PCP) to the rheumatologist.

METHODS:

A descriptive, observational, prospective cohort study was performed. We included patients who visited a PCP for the first time for hands arthralgia. Demographics and the European Alliance of Associations for Rheumatology criteria for arthralgia suspicious for progression to RA plus seven complementary questions, the time to referral, the pressure needed to provoke pain with an automatic squeeze test machine in the metacarpophalangeal joints of both hands, and the diagnoses established at the last review of medical charts from patients on follow-up were documented. The primary outcome was the referral to a rheumatologist.

RESULTS:

A total of 109 patients were included. The mean age was 49.9 years, 81.6% were women. 30.3% were referred to the rheumatologist. The time to referral was a median of 38 days. The main clinical characteristics associated with referral to the rheumatologist were the "most severe symptoms are present after midnight" (OR=6.29) and the "difficulty with making a fist" (OR=3.67). An isolated "positive squeeze test of metacarpophalangeal joints" was not associated with a referral to the rheumatologist.

CONCLUSIONS:

Among patients with hands arthralgia who attended PCP, those with most severe symptoms after midnight and difficulty making a fist were more likely to be referred to the rheumatology clinic. Isolated positive squeeze tests are not a parameter for referral, it should only be performed if arthralgia is clinically suspected.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artrite Reumatoide / Médicos de Atenção Primária Limite: Female / Humans / Male / Middle aged Idioma: En Revista: Reumatol Clin (Engl Ed) Ano de publicação: 2024 Tipo de documento: Article País de afiliação: México País de publicação: Espanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artrite Reumatoide / Médicos de Atenção Primária Limite: Female / Humans / Male / Middle aged Idioma: En Revista: Reumatol Clin (Engl Ed) Ano de publicação: 2024 Tipo de documento: Article País de afiliação: México País de publicação: Espanha