Referrals to an “early synovitis clinic”: are they appropriate?

There is mounting evidence that early disease modifying treatment improves the outcome in patients with rheumatoid arthritis (RA)1 and that treatment should begin before the disease is established and irreversible damage has occurred.2 This evidence has led to the development of “early synovitis clinics” in many rheumatology units to fast track appropriate patients. Early referral for specialist advice has been shown to be associated with improved health and physical function, with the concept of early treatment of RA shortening observation periods before referral in general practice.3 A shortened observation time is important as Irvine et al showed that 73% of patients waiting more …