DUBAI // Patients with arthritis often do not walk into the right doctor's office until it is too late to avoid deformities caused by the disease, experts say.
Arthritis, an inflammation of the joints that affects tissue and organs, affects 20 per cent of the population. However, fewer than 6,000 patients have been diagnosed correctly.
The reason, said Dr Abdulameer Rasheed, a specialist rheumatologist at the Canadian Specialist Hospital in Dubai, is because a person suffering from joint pain heads straight to a general practitioner or to an orthopaedic who often misdiagnose the pain. "Patients with early-stage arthritis don't know that they need a rheumatologist; most don't even know what a rheumatologist does," he said.
"What they feel is a pain or aching in what they think is their bones, so they automatically assume they need a 'bone doctor' and head to an orthopaedic."
In turn, the orthopaedic will prescribe a painkiller that dulls the pain but does nothing to alleviate the progression of the arthritis.
"The problem is neglected until the patient's arthritis is so severe that they go to a rheumatologist towards the end stage, when deformities have set in," he said.
Dr Humeira Badsha, a rheumatoligist at Al Biraa Arthritis Clinic and founder of the Emirates Arthritis Foundation, said that the UAE greatly lags behind other countries in how much time it takes to diagnose a patient and then start treatment.
"Our studies have shown that there is an average delay of 18 months in diagnosis and then a further delay of six months to start proper treatment, so 24 months in total, which is too much time to waste where arthritis is concerned," she said.
Part of the problem, said Dr Rasheed, is that doctors are either misdiagnosing or diagnosing too late due to a lack in training or education.
Dr Badsha said there are other factors: patients tend to go from doctor to doctor instead of remaining with one practitioner, which delays treatment.
Patients also tend to believe that once arthritis sets in, nothing can be done and the only recourse is painkillers.
"This is not true; the patient needs disease-modifying drugs, not painkillers or steroids," she said.
The most viable solution, said Dr Rasheed, is educating the patient.
Early diagnosis, he said, improves the quality of life for the patient and greatly increases the chance of a full recovery, but only if a patient makes it to a rheumatologist in time.
"People should be aware of certain signs and symptoms consistent with rheumatoid arthritis, namely early symptoms of warmth, swelling and pain in the small joints of the fingers, wrists and feet, and morning stiffness that lasts for at least an hour," he said.
Conducting a physical examination to monitor joint swelling, said Dr Badsha, is sometimes not enough.
"Swelling may not always be apparent, so a physical examination is not 100 per cent accurate and another reason why the patient has to see a rheumatologist," she said.
A musculoskeletal ultrasound, for example, can locate internal swelling and diagnose arthritis, Dr Badsha said.
"This all depends on the patient getting to the right doctor in time," she said.