THE SEMIOLOGY OF ARTHRITIS - DISCRIMINATING BETWEEN PATIENTS ON THE BASIS OF THEIR SYMPTOMS

Objectives-To examine the intended meaning of words used by patients t o describe arthritic symptoms, and to distinguish between different pa tient groups on the basis of these words. Methods-A Joint Symptom Ques tionnaire, developed to resemble the McGill Pain Questionnaire, was gi ven to health professionals (n=50) and patients with rheumatoid arthri tis (RA) (n = 100), fibromyalgia (FM) (n = 50), ankylosing spondylitis (AS) (n = 50), and osteoarthritis (OA) (n=50). Respondents were invit ed to define each word by selecting an appropriate heading. Comparison of patient groups was based on the selection of words they chose to d escribe their joint symptoms. Results-Between health professionals and patients there were no semantic differences in the words given. Patie nts with FM chose more words to describe their symptoms than the other patient groups (RA median nine words; AS nine words; OA 10 words; FM 12 words). Using receiver operating characteristic curves, a clear dis tinction between patients with RA, FM, and AS was found, but patients with RA were not readily separated from patients with OA. Conclusions- There appears to be no semeiological confusion between health professi onals and patients regarding arthritic symptoms. However, the spectrum of words chosen by patients to describe the feelings in their joints permits a separation between patients with RA, AS, and FM. Using this questionnaire, patients with RA and OA are symptomatically similar.