ACR drafts checklist for GPs to determine need for rheumatologist

The American College of Rheumatology Simple Tasks campaign has compiled a list of early warning signs of inflammatory rheumatic diseases that general practitioners may use to determine if a rheumatologist referral is needed.

“We want to encourage early and appropriate referral of people with these diseases to rheumatologists,” Audrey Uknis, MD, ACR president, told Healio.com.

Audrey Uknis

Because symptoms of rheumatic disease can be indicative of different disorders, they can be difficult to identify, according to the posting on the campaign’s website. Warning signs may include:

Swelling in the joints, especially multiple joints
Weakness (eg, difficulty rising from a chair), along with elevated erythrocyte sedimentation rate (ESR) and creatine kinase
Fingers or toes presenting new blue or white color changes, particularly accompanied by ulcers
New headaches, with or without visual disturbances, and elevated ESR
Skin on the hands and feet showing new fixed swelling or tightness
New butterfly rash and joint pain or fevers
ESR that is elevated, along with joint pain, swelling, fevers, rash or weakness
Sudden wrist or foot drop, accompanied by fevers and rash
Morning stiffness of more than 45 minutes
Morning back pain that subsides with activity

“Patients with rheumatic diseases have a short window of opportunity (just 12 weeks from symptom onset for some),” according to the campaign, and patients should seek appropriate treatment at that time to avoid long-term complications.

“We hope to reach those whose decisions affect our patients’ ability to access appropriate rheumatologic care — including lawmakers and referring physicians — with the message that the simplest tasks that we may take for granted can become impossible because of rheumatic diseases,” Uknis said.

Physicians may locate a rheumatologist on the ACR’s directory at www.rheumatology.org/directory/geo.asp.