Ellie’s GP recognises that the symptoms may be consistent with a new diagnosis of rheumatoid arthritis, and even before any blood tests are received an urgent referral to the rheumatology department is made.

2 weeks later Ellie is seen in a rheumatology department by a consultant. The consultant reviews her symptoms and examines her. The suspicion of rheumatoid arthritis is confirmed and the consultant explains the diagnosis.

An appointment is then made for Ellie to have a visit with a rheumatology specialist nurse to provide information about the diagnosis and explain the management plans. Written information is also provided from patient organisations (Arthritis Research UK and the National Rheumatoid Arthritis Society).

An intramuscular injection of methylprednisolone is administered and the treatment plan is to commence methotrexate at a dose of 20mg once weekly as well as folic acid 5mg weekly.