Abstract
The focus in the management of rheumatoid arthritis is to slow progression of the disease, by early diagnosis and suppression of the inflammatory process before structural irreversible damage occurs. The predominant clinical feature in early disease is a non-specific polysynovitis. However, 50% of patients with this feature alone have a self-limiting process and not rheumatoid arthritis. 1 Wolfe F Ross K Hawley DJ Roberts K Cathey MA The prognosis of rheumatoid arthritis and undifferentiated polyarthritis syndrome in the clinic: a study of 1141 patients. J Rheumatol. 1993; 20: 2005-2009 PubMed Google Scholar Therefore, the presence of radiological erosions is the accepted marker of potentially progressive disease and justification for therapy with potentially toxic agents, such as methotrexate. Many rheumatologists regard this stage of irreversible damage as late. Can diagnosis be confirmed earlier?
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