LAUSR

Background: Primary care physicians (PCP) are usually the first contact of people with inflammatory rheumatic diseases, and find the early symptoms of Rheumatoid Arthritis (RA) difficult to distinguish from those of other rheumatic diseases. A time-delay in the reference to Rheumatology is a health issue in several countries. The clinical aspects that general practitioner took into account in hand arthralgia patients are important to make the reference. In particular the Squeeze Test (ST) - which is simple to perform and rapidly done, ST is useful for identifying progression to RA in patients with undifferentiated arthritis. The ST has been described as not reliable because is clinician-dependent. Objectives: To identify the required force that needs to be applied in order to obtain a positive Automatized Squeeze Test (AST) in a cohort of patients with hand arthralgia. Methods: Ninety-seven patients were recruited in Family Medicine Consultation and in Rheumatology Consultation of the Hospital Universitario “Dr. José Eleuterio González” in Monterrey, Nuevo León, México. Eligible patients were adults (aged≥18 years) with hand arthralgia (that wasn’t caused by trauma) as their chief complaint. After obtaining informed consent and after a questionnaire application, patients were submitted to AST maneuver, using an automated compressor with different forces already predetermined in the interface of the software used for compression. Results: In this cohort of 98 patients, 79 (80.6%) were women. The mean age was 51.14 years (SD 14.66). Ninety-six (97.9%) patients were right handed. The diagnoses were Osteoarthritis (OA) (16.3%), RA (5.1%), Undifferentiated arthritis (1.2%), Psoriatic arthritis (1.2%) and Fibromyalgia (2%). Force measures according to diagnoses are reported in Table 1.Table 1. Diagnoses and mean forces Diagnosis n (%) Right hand force mean (kg/s2) (SD) Left hand force mean (kg/s2) (SD) OA 16 (16.3) 3.53 (2.74) 3.18(2.73) RA 5 (5.1) 3.60 (2.53) 3.16(1.36) UA 1 (1.2) 7.60(0) 8.70(0) PsA 1 (1.2) 7.60(0) 7.80(0) FM 2 (2.0) 4.11(4.40) 1.75(1.06) OA, Osteoarthritis; RA, Rheumatoid Arthritis; UA, Undifferentiated Arthritis; PsA, Psoriatic Arthritis; FM, Fibromyalgia; SD, Standard Deviation Conclusion: In the cases of RA and OA, the means of force to obtain a positive AST was lower than in the rest of the diagnoses. References: [1]Stack R, Nightingale P, Jinks C, Shaw K, Herron-Marx S, Horne R et al. Delays between the onset of symptoms and first rheumatology consultation in patients with rheumatoid arthritis in the UK: an observational study. BMJ Open. 2019;9(3):e024361. Disclosure of Interests: None declared