A major new study from the University of Birmingham has shown that many patients with rheumatoid arthritis are missing out on early diagnosis and treatment because they are not seeking medical advice when their symptoms first develop.

The Arthritis Research Campaign-funded study of 169 patients in Birmingham showed that there was an average delay of nearly six months between the initial onset of symptoms and patients being assessed by a rheumatologist in hospital.

The researchers found that the majority of delays occurred because sufferers failed to seek medical advice at an early stage. On average patients waited three months from the onset of symptoms before visiting their GP. In the majority of cases this accounted for more than half the delay in getting an assessment from a rheumatologist.

The paper is published in the current edition of the journal Rheumatology.

Data were collected from patients with newly presenting rheumatoid arthritis attending the rheumatology clinics at Sandwell and West Birmingham Hospital NHS Trust. Patients were asked when their symptoms first began and when they first saw their GP.

Dr Karim Raza who led the research team comments: “Rheumatoid arthritis is relatively common, affecting 1% of the population. Research over the last 10 years has led to major advances in our ability to treat this condition effectively. However, current treatments are much more effective if commenced early in the course of disease.

 “An early diagnosis is thus extremely important. Our research showed that although there can be delays in referring patients to a specialist the biggest problem is in encouraging patients to make an initial appointment with their doctor.

“This may be because patients don’t realise the potential seriousness of painful, stiff, swollen joints and the possible long term complications if effective treatment is not started early.”

The research showed that while the delay in making a visit to the GP was around 12 weeks, the delays in getting referred and seen by a specialist were significantly shorter. On average patients were referred to hospital within two weeks and given an appointment with a rheumatologist within a further three weeks.

Dr Raza continues “The reasons for this delay are unclear. The delay was not affected by the age or sex of the patient and more work needs to be  done to fully understand why patients don’t choose to consult their doctor at an early stage.

“This doesn’t mean that there shouldn’t be continued efforts to tackle any delays in getting appointments with consultant rheumatologists, but we are now looking at developing better educational programmes to try and encourage patients with relevant symptoms to seek medical advice.

“It is important that patients are able to take advantage of the great advances in treatment by seeking help early.”

For more information or to request a copy of the paper please contact Ben Hill, Press Officer, University of Birmingham, Tel 0121 4145134, Mob 07789 921 163

The paper: Delay in presentation to primary care physicians is the main reason why patients with rheumatoid arthritis are seen late by rheumatologists – is published in the current edition of Rheumatology


Notes to Editors


The School has a long history of serving a national need, and has been providing excellence in medical education for nearly two centuries.  Most recently, the School has shown its commitment to the local area by the successful expansion of the School of Medicine, doubling its medical student intake in the last five years.  Over 85% of students stay in the area in which they trained, once they have qualified.

The School of Medicine has a strong record and extensive experience in providing and managing clinical learning involving sixty-five general practices and sixteen teaching hospitals. All sixteen teaching hospitals, and an increasing number of teaching General Practices are linked to the University by a broadband IT virtual campus supported by a web – enabled e-learning and an electronic curriculum, resources; that will strengthen the learning experience for students.


The Arthritis Research Campaign is the fourth-largest medical research charity in the UK, funding research into all types of arthritis and musculoskeletal conditions. In 2006-7 it raised more than £32m from public donations. It currently funds £2.5m of research at the University of Birmingham, a leading arc-funded centre.