In India, there is delay in diagnosis of Rheumatoid Arthritis

By Bimlesh Dhar Pandey

A 57-year-old patient from Delhi in 2021 witnessed an onset of symptoms like joint pains, stiffness and slight swelling in joints. Assuming it to be muscle pull or result of excessive walking, the patient ignored the symptoms for few months. Further, when the symptoms failed to disappear, visit to the general physician was scheduled and treatment continued for few weeks. It was only after 10 months that the patient referred a rheumatologist for further treatment and was diagnosed with rheumatoid arthritis or inflammatory arthritis. While this is the story of a middle-aged patient, this holds true for majority of the patients suffering from Rheumatoid Arthritis in India.

Rheumatoid arthritis, often mistaken as osteoarthritis, is not a simple disease. Unlike osteoarthritis, Rheumatoid arthritis can have long-term implications like deformities and impacts functioning of kidneys, lungs etc. Most of the patients suffer from irreversible damage and disability, post onset of symptoms. Hence, early detection and treatment is imperative for disease remission and preventing disability or joint damage.

Not many are aware, significant delay in diagnosis and treatment of rheumatoid arthritis can lead to reduced mobility, poor quality of life and inflammation in the affected joints.

Reasons for delay:

If considered the patient journey suffering from Rheumatoid Arthritis, most of the cases are initially treated for osteoarthritis, primarily due to the presentation of similar symptoms. Also, in some conditions, the symptoms may be quite vague, indicating non-functionality of one organ and ignoring the over-arching diagnosis of Rheumatoid Arthritis, in particular.

Moreover, majority of the patients ignore the symptoms for the first few months and avoid seeking medical help. This further reduces the window period for treatment and delays the diagnosis period. With this, even if medical help is sought after a long time, the focus area remains the non-functionality of one organ or the basic symptoms.

To add to this, lack of awareness among patients and society at large is a significant factor that leads to delay in diagnosis of the disease.

Global studies have found that early diagnosis and initiating treatment within first few months if diagnosis the disease can significantly reduce the progression of the disease. According to Study published in National Library of Medicine in 2022, most of the patients in India miss the three-month therapeutic window for effective treatment of rheumatoid arthritis. Treatment includes Biologics or Disease Modifying Antirheumatic medications.

Diagnosis and Treatment of Rheumatoid Arthritis

To ensure early diagnosis, it is important for patients not to ignore slightest sym ptoms of joint pains. If the patient observes joint pain on both sides and experience stiffness of joints in the morning, the symptoms should not be ignored and requires immediate consultation.