referral criteria from primary care - suspected rheumatoid arthritis (RA)
Last edited 10/2018 and last reviewed 01/2023
Refer for specialist opinion any adult with suspected persistent synovitis of undetermined cause.
Refer urgently (even with a normal acute-phase response, negative anti-cyclic citrullinated peptide [CCP] antibodies or rheumatoid factor) if any of the following apply:
- the small joints of the hands or feet are affected
- more than one joint is affected
- there has been a delay of 3 months or longer between onset of symptoms and seeking medical adviceNotes:
- suggested nvestigations
- rheumatoid factor in people with suspected RA who are found to have synovitis on clinical examination
- consider measuring anti-cyclic citrullinated peptide (CCP) antibodies
in people with suspected RA if:
- they are negative for rheumatoid factor, and
- there is a need to inform decision-making about starting combination therapy
- x-ray the hands and feet early in the course of the disease in people with persistent synovitis in these joints
Reference: