Rheumatology

Rheumatoid Arthritis

SPECIALTY
Rheumatology

CHIEF COMPLAINT
Rheumatoid Arthritis

COMMENTS TO SPECIALIST
53-year-old male presents with joint pain for >6 weeks. The joint pain does affect both small and large joints. The patient has a history of obesity, s/p spinal fusion, reported fibromyalgia, and rheumatoid arthritis (RA) since the age of 15. Recently diagnosed with type 2 diabetes. Previously ambulatory without assistance; now using a wheelchair. A physical exam is normal except:

• Shoulder shrug is equal but weak.
• Right-hand grasp is weak and tremoring during purposeful grasping of my hand.
• Left-hand grasp is moderate.
• There is a very mild swan neck deformity noted.
• Pedal pushes and pulls are equal and weak.
• Limited range of motion in all the joints.
• The patient was unable to tolerate me moving his extremities through a complete range of motion due to subjective pain and muscle spasticity.
• There is inflammation noted in the shoulders, hands, and feet joints.

No erythematous joints noted. There are no ictal signs. Deep tendon reflex (DTR) intact. The patient was started on steroids.

MAIN QUESTION
Please provide expert treatment recommendations, as necessary.

How eConsults Support Patient Access to Comprehensive Rheumatology Care for Arthritis

With long specialist wait times, providers across the country are turning to eConsults to offer comprehensive rheumatology care. They often help patients manage chronic conditions like rheumatoid arthritis while dealing with the realities of limited access to specialists. Specialist shortages, limited access, and long wait times for specialty care can negatively impact patient outcomes.

Electronic physician-to-specialist consultations, or eConsults can help mitigate the challenge of specialist shortages and other delays in treatment by offering comprehensive rheumatology care. An eConsult is an asynchronous physician-to-physician communication about a patient, conducted over a secure digital platform, that enables PCPs to leverage the expertise of physician specialists like rheumatologists. eConsults gives patients immediate access to specialists from within a primary care setting.

We use rheumatoid arthritis, a disease that affects about 1.5 million US adults, as an example of how eConsults can help PCPs work with specialty physicians to manage a chronic, complex disease.