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Identifying arthralgia suspicious for progression to rheumatoid arthritis

We read with interest the article by van Steenbergen et al 1 in which a definition for arthralgia suspicious for progression to rheumatoid arthritis (RA) was proposed. The authors used a three-phase Delphi exercise to crystallise the concept of clinically suspect arthralgia (CSA), which is inherently subjective, into a core set of definable parameters. We agree that this set of characteristics should provide a useful secondary care framework for identifying homogeneous at-risk populations for future clinical studies. Recent data suggest that rheumatologists can use symptoms and signs to identify which patients with arthralgia referred to them will imminently develop RA.2 ,3 In the current cohort, up to 20% of individuals identified as CSA by their rheumatologist developed RA during follow-up, the majority doing so …