Patients with rheumatoid arthritis first presenting to a rheumatology unit with severe established disability

Summary

During a 2 year period, 33 patients with rheumatoid arthritis first presented to a rheumatology unit after developing severe disability. The mean duration of disease prior to first referral was 15 years. Clinical assessment confirmed the presence of permanent deformities in all, and of continuing disease activity in the majority. All were significantly handicapped in normal daily activities. Despite advanced disease the provision of standard therapeutic modalities had been erratic prior to referral. Possible causes of treatment deficiencies in this group of patients are examined.