Delayed Diagnosis and Treatment of Rheumatoid Arthritis: A Preventable Path to Disability

Nauman Ismat Butt; Barak Waris; Umaima Waris

doi:10.5455/ajdi.20250531043655

Abstract
Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes joint pain, swelling, and long-term disability if not treated early. It affects over 18 million people worldwide and is a leading cause of disability among musculoskeletal conditions. This letter presents the case of a 42-year-old woman who suffered severe joint deformities due to delayed diagnosis and lack of treatment for over seven years. Despite early symptoms and radiographic signs of RA in 2021, the patient did not receive consistent care due to misinformation, social stigma, and fear of medication side effects. By the time she was properly evaluated in 2025, she had significant loss of hand function and independence. Her case highlights the critical importance of early recognition, diagnosis, and treatment of RA particularly within the first 12 weeks of symptom onset, known as the "window of opportunity," when disease-modifying antirheumatic drugs (DMARDs) are most effective. Delayed intervention often leads to irreversible joint damage and disability. To reduce this burden, the authors call for increased public awareness, improved training for healthcare providers, clear referral pathways, and broader access to rheumatology care. Early detection and education can prevent unnecessary disability and improve the lives of individuals living with RA.

Key words: Rheumatoid Arthritis, Deformities, Disability, Rheumatologist, Juxta-articular Osteopenia, Marginal Erosions, Radiography