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Rheumatoid arthritis (RA) is an inflammatory connective tissue disease with both articular and extra articular manifestations. Early diagnosis and proper treatment affect strongly the patients’ quality of life. In the early phase of the disease, effective treatment and strict monitoring would help to achieve remission within the shortest period. Delay in detection of these cases and consequently late referral to a rheumatologist result in loss of the golden time when effective treatment must start. Delay of patients’ referral by the family physician was the most statistically significant factor responsible for the delay in starting of a specific therapy for RA. Clear guidelines according to 2016 update of the EULAR recommendations for the management of early arthritis (Combe et al., Ann Rheum Dis 76:948–959, 2017) must be known to all primary care physicians to suspect RA and to avoid delay in referral of patients.

Delay in referral of rheumatoid arthritis patients to rheumatology clinic