Early Inflammatory Arthritis (EIA)

We are developing our EIA service in line with NICE and BSR guidelines and around our patients’ needs. 

All referrals are triaged by the consultants and we aim to see suspected early inflammatory arthritis cases within 3 weeks from receipt of referral.  Referrals should be submitted with a completed proforma. 

Please refer patients with suspected persistent joint inflammation of 4 weeks or more AND any one of the following:

  1. Swelling of 3 or more joints
  2. Swelling of the small joints of hands or feet
  3. Positive MCPJ or MTPJ “Squeeze test” (i.e. pain produced by squeezing across the metacarpophalangeal/etatarsophalangeal joints)
  4. Early morning joint stiffness (EMS) >30mins

Please note the diagnosis of Early Inflammatory Arthritis is not excluded by normal inflammatory markers and / or a negative rheumatoid factor and/or normal Xrays.

We aim to make a diagnosis and start disease-modifying drugs within 6 weeks from time of referral or discharge patients back if not EIA.

People diagnosed with EIA have regular clinical reviews by the multidisciplinary team for education, self-management, monitoring of disease activity, therapeutic benefit and treatment safety.

Referrals will only be accepted with a completed Referral pathway to the Early Inflammatory Arthritis Service (EIA Service) - 3 week wait attached to the eReferral.


Patients not meeting these criteria should be referred to general rheumatology clinics.

Please refrain from using steroids until the patient has been seen in clinic as this makes assessment very difficult.

Early Inflammatory Arthritis (EIA)