The Journey of Transformation in Rheumatology: From Delayed Diagnoses to Early Intervention

Key Highlights :

1. Rheumatoid arthritis afflicts around 1% of the population.

2. The landscape has shifted dramatically over the past three decades. Today, patients with rheumatoid arthritis come in much earlier, usually within the first few months of joint pains and other symptoms.

3. Being early in the disease course, they have no deformities but have symptoms of early morning stiffness (of more than 1/2 hour) and joint swelling.

4. Combining clinical examination and newer lab tests and Ultrasound / MRI, if needed, has enabled an early diagnosis of rheumatoid arthritis.

5. Newer lab tests and radiological tools to diagnose this disease also became available. The excitement triggered by these new developments also helped rheumatology as a speciality to come into its own.

     Rheumatoid arthritis is a chronic condition that affects around 1% of the population. It is characterized by painful joint inflammation, leading to severe deformities in the hands and feet, as well as dry eyes, mouth, and even lung issues. In the early nineties, patients with rheumatoid arthritis were diagnosed about 3 to 10 years after the onset of symptoms. Awareness and understanding of this disease were limited, and there were only a couple of effective drugs and very few rheumatologists in a large metro like Mumbai to treat these patients.

     Fast-forward to 2023, and the landscape has shifted dramatically. Patients with rheumatoid arthritis now come in much earlier, usually within the first few months of joint pains and other symptoms. Combining clinical examination and newer lab tests and Ultrasound/MRI, if needed, has enabled an early diagnosis of rheumatoid arthritis. This has helped spread awareness about early diagnosis and treatment of arthritis among the medical fraternity and improved the outcome of this once dreaded/hopeless disease.

     Newer lab tests and radiological tools to diagnose this disease have also become available. This has helped rheumatology as a speciality come into its own. With postgraduate institutes starting super speciality programmes in rheumatology, the number of trained rheumatologists in Mumbai has increased to over 50. This has led to an increased understanding of the disease and the development of new treatments.

     The journey from delayed diagnoses and limited treatment options to early intervention and advanced therapies represents a substantial transformation in rheumatology. This transformation underscores the pivotal role of disease awareness, early diagnosis and treatment, upskilling and training to improve patients' quality of life. It is a testament to the power of modern medicine and the importance of investing in medical research and training to improve the lives of those living with chronic conditions.

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