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DOI: 10.1016/j.reumae.2020.05.004
Available online 4 February 2021
Delay and diagnostic pathway of patients with psoriatic arthritis in Spain
Retraso y recorrido diagnóstico de pacientes con artritis psoriásica en España
Carlos Antonio Guillen Astetea,b,c,
Corresponding author

Corresponding author.
, Irene Gaite Gonzalezb, Pablo Antonio Zurita Pradab,c, Claudia Urrego Laurinb,c
a Servicio de Reumatología, Hospital Universitario Ramón y Cajal, Madrid, Spain
b Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
c Unidad de Reumatología, Hospital Universitario HLA Moncloa, Madrid, Spain
Received 12 January 2020. Accepted 13 May 2020
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Tables (2)
Table 1. Summary of the results of the consultation pathway to different specialities prior to the diagnoses of psoriatic arthritis.
Table 2. List of specialities from where the referral was made which finally led to the diagnosis of psoriatic arthritis.
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Introduction and objectives

Delayed diagnosis results in a worse prognosis in patients with psoriatic arthritis. Our objective is to determine the diagnostic delay, the specialties consulted and the referral points of patients with psoriatic arthritis in our environment.

Patients and methods

We distributed a survey to members of the Spanish association Acción Psoriasis inquiring about the objectives of the study.


A total of 503 surveys were analysed. The diagnostic delay was 4.01 ± 1.42 years. The proportion of patients who had consulted, before diagnosis, primary care was 79.9%, traumatology 33.8% and the emergency department was 30.2%. The proportion of referrals that eventually led to diagnosis came from primary care in 29.3% of cases, traumatology 15.8% and the emergency department 3.5%.

Discussion and conclusions

The delay in diagnosis far outweighs other European results. Emergency departments are an important transit point for these patients, but the proportion of referrals is very low. We believe that focusing on the importance of early diagnosis in this particular medical sector could resolve a large part of diagnostic delay.

Psoriatic arthritis
Diagnostic delay
Early diagnosis
Introducción y objetivos

El retraso diagnóstico condiciona un peor pronóstico en pacientes con artritis psoriásica. Nuestro objetivo es determinar el tiempo de retraso diagnóstico, las especialidades consultadas y los puntos de derivación de pacientes con artritis psoriásica en nuestro medio.

Pacientes y métodos

Distribuimos una encuesta entre los miembros de la asociación española Acción Psoriasis indagando sobre los objetivos del estudio.


Se analizaron 503 encuestas. El tiempo de retraso diagnóstico fue de 4,01 ± 1,42 años. La proporción de pacientes que habían consultado, antes del diagnóstico, con atención primaria fue del 79,9%, con traumatología, del 33,8% y por urgencias, del 30,2%. La proporción de derivaciones que finalmente condujeron al diagnóstico provinieron de atención primaria en el 29,3% de los casos, de traumatología en el 15,8% y de urgencias en el 3,5%.

Discusión y conclusiones

El retraso diagnóstico detectado supera extensamente otros resultados europeos. Los servicios de urgencias ocupan un lugar importante de tránsito de estos pacientes, sin embargo, la proporción de derivaciones es muy bajo. Entendemos que incidir en este gremio médico en particular sobre la importancia del diagnóstico precoz podría resolver gran parte del retraso diagnóstico.

Palabras clave:
Artritis psoriásica
Retraso diagnóstico
Diagnóstico precoz


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