Gradual Onset Diseases: Misperception of Disease Onset

Area of Science:

• Orthopedics
• Hand Surgery
• Musculoskeletal Diseases

Background:

• Gradual onset diseases, such as carpal tunnel syndrome, cubital tunnel syndrome, and trapeziometacarpal arthrosis, often develop insidiously over years.
• The transition from an asymptomatic to symptomatic phase can lead patients to perceive the disease onset as acute or recent.

Purpose of the Study:

• To determine the percentage of patients who perceive their slowly progressive disease as having started within the past year.
• To investigate factors associated with the perception of recent disease onset, particularly in advanced stages.
• To compare the decision to pursue operative treatment between patients with perceived recent versus long-standing disease onset.

Main Methods:

• A retrospective review of 732 patients diagnosed with carpal tunnel syndrome, cubital tunnel syndrome, or trapeziometacarpal arthrosis.
• Assessment of symptom onset perception and factors influencing it.
• Bivariate and multivariable analyses to evaluate associations with perceived recent onset and choice of operative treatment.

Main Results:

• 69% of all subjects and 68% of patients with advanced disease perceived their condition as having started within the last year.
• Perceived provocation, such as injury or surgery, was linked to the perception of recent onset.
• No significant difference was found in the decision to pursue operative treatment between patients perceiving recent versus long-standing onset.

Conclusions:

• Slowly progressive musculoskeletal conditions are frequently misperceived by patients as having a recent onset.
• Effective patient communication is crucial to address these misconceptions and ensure treatment decisions align with patient values.