Causes of Pitfalls in Diagnosis of Rheumatoid Arthritis in Aswan University Hospital

Abstract

Background - Rheumatoid arthritis (RA) is a symmetric, peripheral polyarthritis. It leads to deformity through the stretching of tendons and ligaments and destruction of joints through the erosion of cartilage and bone.Aim - to determine the causes of overdiagnosis of rheumatoid arthritis in Aswan university hospital rheumatology departmentPatients and Methods - In this cross sectional study, 50 patients were included in the study selected from Rheumatology outpatient clinics, Aswan University Hospitals, Faculty of Medicine, Aswan University.Results - 6 Cases were male and 44 were female and their ages ranged between 22 to 70 years (mean 48.52±14.16 years), the median complaint duration (years) were 24±5.58 (12 – 48). 18 (36.0%) Cases Positive Morning stiffness and 32 (64.0%) were negative Morning stiffness and it ranged from 5 to 70 minutes (Median 26.67±21.49).40(36%) patients were misdiagnosed due to bilateral hand arthralgia , 18(36%) patients due to diagnosis by speciality other than rheumatology , 18(36%) patients due to RF positivity , 17(34%) patients due to presence of morning stiffness. Conclusion - RA misdiagnosis was associated with numerous factors, including the health care practitioner, community knowledge, overlapping symptoms between RA and other diseases, and laboratory error factors.