Use of Rheumatologic Testing in Patients who Eventually Receive a Diagnosis of Rheumatoid Arthritis

Dilpreet K. Singh, MD; Jasdeep Badwal, MD; Ritika Vankina, MD; Santhi Gokaraju, MD; Jennifer Friderici, MS; Scott Halista, MD; Tara Lagu, MD, MPH


South Med J. 2019;112(10):547-550. 

In This Article


Most PCPs failed to order diagnostic tests for RA before referring a patient with polyarthritis who eventually received a diagnosis of RA. In particular, PCPs failed to order ACPA in 61% of referred patients who eventually received a diagnosis of RA. Failure to order ACPA did not appear to significantly delay the initiation of RA treatment once the patient had been seen by a rheumatologist, and we could not determine the impact of testing (or lack of testing) on referrals. These findings suggest that educational efforts for PCPs and quality improvement efforts in primary care settings should focus on emphasizing earlier diagnostic workup, especially ACPA, in patients suspected to have RA.