The semeiology of arthritis: discriminating between patients on the basis of their symptoms

OBJECTIVES–To examine the intended meaning of words used by
patients to describe arthritic symptoms, and to distinguish
between different patient groups on the basis of these words.

METHODS–A Joint Symptom Questionnaire, developed to resemble
the McGill Pain Questionnaire, was given to health
professionals (n = 50) and patients with rheumatoid arthritis
(RA) (n = 100), fibromyalgia (FM) (n = 50), ankylosing
spondylitis (AS) (n = 50), and osteoarthritis (OA) (n = 50).
Respondents were invited to define each word by selecting an
appropriate heading. Comparison of patient groups was based on
the selection of words they chose to describe their joint

RESULTS–Between health professionals and patients
there were no semantic differences in the words given.
Patients 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 distinction 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 professionals 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.
EM- 9603

Helliwell PS

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