Symptoms associated with inflammatory arthritis are common in the primary care population: results from the Joint Symptoms Survey

Objectives: 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. Methods: A Joint Symptoms questionnaire survey was sent to 10,161 individuals, of whom 5,050 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 was compared between MSK and non-MSK consulters. Results: 4,549 adults responded to the survey (adjusted response 45.8%) of whom 52.3% consulted for a musculoskeletal problem. The mean (SD) 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 to 62% reporting joint pain, 50% stiffness and 24% swelling amongst MSK consulters. Conclusions: Although symptoms such as persistent joint pain, swelling, and stiffness are predictive of inflammatory arthritis, large numbers of people consulting primary care for non-musculoskeletal 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