Women More Apt to Seek Musculoskeletal Care Before Inflammatory Arthritis Diagnosis

Before diagnosis, women with inflammatory arthritis were more likely than men to visit family physicians and rheumatologists for musculoskeletal reasons and to undergo imaging and laboratory tests, according to a study published in the Annals of the Rheumatic Diseases.

“On the other hand, use of emergency care for musculoskeletal reasons was more common in male patients,” wrote corresponding author Lihi Eder, MD, PhD, of Women’s College Hospital in Toronto, Canada, and coauthors. “These differences were more pronounced in older patients compared with their younger counterparts.”

The study investigated patterns of health care use among men and women before and after diagnosis of inflammatory arthritis. The analysis included 6446 patients with psoriatic arthritis, 41,277 patients with rheumatoid arthritis, and 8150 patients with ankylosing spondylitis. Women comprised more than half the sample for each specific diagnosis.

For all 3 cohorts, sex-related differences were similar, the study found. Compared with male patients, female patients demonstrated odds ratios between 1.32 and 2.28 for rheumatologist visits for musculoskeletal reasons before their diagnosis, and between 1.03 and 1.15 for family physician visits for musculoskeletal reasons before diagnosis. However, for emergency department visits for musculoskeletal reasons, odds ratios were between 0.76 and 0.87 for female patients compared with male patients.

Women demonstrated predominance for musculoskeletal imaging and laboratory testing before diagnosis as well. After diagnosis, women were more likely to continue with rheumatology care: odds ratios were between 1.12 and 1.24, the study showed.

“Female patients with inflammatory arthritis have higher health care utilization than male patients,” researchers wrote, “which may indicate biological differences in disease course or sociocultural differences in health care-seeking behavior.”

—Jolynn Tumolo

Reference:

Tarannum S, Widdifield J, Wu CF, Johnson SR, Rochon P, Eder L. Understanding sex-related differences in healthcare utilisation among patients with inflammatory arthritis: a population-based study. Ann Rheum Dis. 2023;82(2):283-291. doi:10.1136/ard-2022-222779