As primary care clinicians are typically the first point of contact for patients with musculoskeletal problems, they are crucial to the early diagnosis and treatment of patients with an incident inflammatory arthritis, like rheumatoid arthritis. Current UK and international guidelines recognise this, recommending the prompt referral of patients with suspected persistent synovitis to secondary care. In England and Wales, this is advised to occur within 3 working days. However, recent audit data suggests this recommendation is infrequently met, with some patients waiting many months for referral. In this review article we will discuss the various challenges to achieving the early referral of patients with a new-onset inflammatory arthritis from primary to secondary care. We will also describe how these challenges could potentially be overcome, with the ultimate goal of ensuring that the right patients are referred to the right services, and at the right time.

由于初级保健临床医生通常是肌肉骨骼问题患者的首要联系点，因此对于早期诊断和治疗诸如类风湿性关节炎等炎症性关节炎患者至关重要。当前的英国和国际准则对此予以认可，建议立即将疑似持续性滑膜炎的患者转诊至二级医疗机构。在英格兰和威尔士，建议在3个工作日内完成。但是，最近的审计数据表明，很少有人满足此建议，有些患者需要等待数月才能转诊。在这篇综述文章中，我们将讨论实现从初级保健到二级保健的新发炎性关节炎患者的早期转诊的各种挑战。我们还将描述如何潜在地克服这些挑战，