Laboratory and radiological data collection

Following completion of the screening and examinations within both the community and hospital data capture, adult patients with evidence of synovitis or joint swelling will have 20mL blood taken for later analysis of acute phase reactants (ESR, CRP) and autoantibodies (RF, CCP, antinuclear antibodies, other antibodies as relevant).

Patients below 18 years of age will likewise have a maximum of 20mL of blood taken, but not exceeding 3mL per kg.

Ultrasound will also be performed on all patients with swollen joints and results will be stored securely with the patients’ medical records according to this study’s data management plan.

Patients with suspected arthritis will be referred to KCMC Rheumatology clinic for clinical management, which may involve x-ray of hands and other affected joints.

All patients with articular abnormalities will also undergo ultrasound examination done by a radiologist, research assistant or physician who have been trained specifically to undertake joint ultrasound examination.

Local protocols for clinical decision making informed by these additional diagnostics will be developed by local physicians and paediatricians involved in this study, in consultation with the rheumatologists in Glasgow/Newcastle who are part of the study team, to ensure consistency in clinical process, decision making and sign posting for onwards management.