Unrecognised Inflammatory Arthritis with Joint Destruction

Rheumatoid arthritis (RA) is the most common and serious form of inflammatory arthritis. Untreated it results in joint destruction and functional impairment. A clinical evaluation remains the cornerstone for evaluating early arthritis; determining whether arthritis is present or not, differentiating between the inflammatory or non - inflammatory disease, and deciding on the aetiology of the arthropathy [1]. Articular symptoms may be the presenting manifestations of many infectious, inflammatory or malignant c onditions. There are certain difficulties in making an accurate diagnosis of rheumatoid arthritis in its early stages, a principal problem being the fact that its most defining feature is chronicity, which, by definition, takes time to identify [2]. After 2010 the ACR – EULAR RA classification criteria for RA have been implemented ( This criteria set has been approved by the American College of Rheumatology (ACR) Board of Directors and the European League Against Rheumatism (EULAR) Executive Committee) , identifying patients with a relatively short period of symptoms who would benefit from early diagnosis, has become more easier, giving practical value towards the commencement of early effective treatment, thus preventing the adverse sequelae of the disease [3].