Location
Suwanee, GA
Start Date
17-4-2026 12:00 PM
End Date
17-4-2026 1:00 PM
Description
Introduction
Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that affects the synovial lining of joints and may lead to progressive joint destruction, disability, and premature mortality if inadequately treated. Increasing evidence demonstrates that social determinants of health, particularly socioeconomic status (SES), significantly influence disease outcomes in patients with RA. Studies have shown that individuals of lower SES experience higher disease activity scores, greater physical disability, and poorer quality of life compared with patients of higher SES. Additionally, lower SES has been associated with longer delays between diagnosis and initiation of disease-modifying antirheumatic drugs (DMARDs), contributing to disease progression and preventable complications. This poster examines the relationship between SES and RA severity and presents a case highlighting the disproportionate disease burden experienced by a young patient of lower socioeconomic status.
Methods
A case analysis was conducted involving a 29-year-old African American female admitted to the internal medicine service with pericardial effusion secondary to severe, unmanaged rheumatoid arthritis. Information regarding the patient’s medical history, disease course, and socioeconomic background was obtained through chart review and patient interview. Clinical photographs of affected joints were obtained with appropriate consent to document disease severity. In addition, a structured literature review was performed to evaluate existing research on the relationship between socioeconomic status and rheumatoid arthritis progression and outcomes.
Results The patient was initially diagnosed with rheumatoid arthritis at age 21 but experienced limited long-term disease management. At presentation, she demonstrated severe flexion contractures of both hands and knees, resulting in loss of ambulation and significant impairment in activities of daily living. She was initially diagnosed in 2019 and did not begin DMARDs until 2023, demonstrating a 4 year delay in DMARD initiation. Continued management was significantly hindered by socioeconomic barriers, particularly limited transportation despite established rheumatology follow-up. The patient relied on Medicaid-supported caregiving services and did not have access to personal transportation. Furthermore, her severe, unmanaged disease necessitated highly specialized care at an urban hospital which exacerbated her transportation challenges. This combination of factors lead to inconsistent access to specialty care and further progression of disease severity.
Discussion:
This case illustrates the impact of socioeconomic barriers on RA progression. Furthermore, the data highlights the public health issue of managing rheumatoid arthritis in underserved populations, and the need for increased efforts in ensuring these patients receive adequate care.
Embargo Period
6-1-2026
Included in
Case Report Highlights Disproportionate Health Outcomes of Rheumatoid Arthritis in Patients of Lower Socioeconomic Status
Suwanee, GA
Introduction
Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that affects the synovial lining of joints and may lead to progressive joint destruction, disability, and premature mortality if inadequately treated. Increasing evidence demonstrates that social determinants of health, particularly socioeconomic status (SES), significantly influence disease outcomes in patients with RA. Studies have shown that individuals of lower SES experience higher disease activity scores, greater physical disability, and poorer quality of life compared with patients of higher SES. Additionally, lower SES has been associated with longer delays between diagnosis and initiation of disease-modifying antirheumatic drugs (DMARDs), contributing to disease progression and preventable complications. This poster examines the relationship between SES and RA severity and presents a case highlighting the disproportionate disease burden experienced by a young patient of lower socioeconomic status.
Methods
A case analysis was conducted involving a 29-year-old African American female admitted to the internal medicine service with pericardial effusion secondary to severe, unmanaged rheumatoid arthritis. Information regarding the patient’s medical history, disease course, and socioeconomic background was obtained through chart review and patient interview. Clinical photographs of affected joints were obtained with appropriate consent to document disease severity. In addition, a structured literature review was performed to evaluate existing research on the relationship between socioeconomic status and rheumatoid arthritis progression and outcomes.
Results The patient was initially diagnosed with rheumatoid arthritis at age 21 but experienced limited long-term disease management. At presentation, she demonstrated severe flexion contractures of both hands and knees, resulting in loss of ambulation and significant impairment in activities of daily living. She was initially diagnosed in 2019 and did not begin DMARDs until 2023, demonstrating a 4 year delay in DMARD initiation. Continued management was significantly hindered by socioeconomic barriers, particularly limited transportation despite established rheumatology follow-up. The patient relied on Medicaid-supported caregiving services and did not have access to personal transportation. Furthermore, her severe, unmanaged disease necessitated highly specialized care at an urban hospital which exacerbated her transportation challenges. This combination of factors lead to inconsistent access to specialty care and further progression of disease severity.
Discussion:
This case illustrates the impact of socioeconomic barriers on RA progression. Furthermore, the data highlights the public health issue of managing rheumatoid arthritis in underserved populations, and the need for increased efforts in ensuring these patients receive adequate care.