Delay in diagnosis of spondarthritis

A survey was made of referral patterns and investigative procedures in 125 patients with HLA-B27 related spondarthritic diseases reviewed in the rheumatology department of a district general hospital. At the time of referral a large proportion of the patients had already been seen by other hospital departments for the same complaint although in many cases such referrals did not result in a correct diagnosis. Multiple referrals had often resulted in prolonged diagnostic delay during which time unnecessary and invasive investigations were performed. The data indicate the need for improved diagnostic awareness of common rheumatic conditions by all clinicians dealing with musculoskeletal disease.