A 1-page referral tool that includes parts completed by the referring physician and patient has good sensitivity to detect urgent referrals including EIA.

SUMMARY Fifteen patients presenting with inflammatory polyarthritis who had Hashimoto's thyroiditis were investigated. Only 2/15 had frank myxoedema, 8/15 had incipient hypothyroidism (raised levels of thyrotropin or early symptoms of mild hypothyroidism), and 5/15 were euthyroid (thyrotropin levels normal). The presence or absence of rheumatoid factor (RF) distinguished two subgroups with different severity of synovitis. said not to be tender and to lack other signs of inflammation.We have encountered a small group of patients presenting with inflammatory polyarthritis (IP) who were found to have Hashimoto's thyroiditis in the course of investigation. In contrast to previous reports of the arthropathy associated with hypothyroidism most of the patients we studied had little or no evidence of hypothyroidism at presentation. These patients were evaluated further in order to attempt to determine the relationship between their inflammatory thyroid disorder and polyarthritis. The results of an initial and follow-up clinical and serological assessment of these patients forms the basis of the present report. Patients and methodsFifteen Caucasian patients were studied, of whom one was male. Their average age was 50-3 years (range 23-71 years). They presented initially in the Rheumatology Outpatient

Low health literacy is an important issue in the southwestern Ontario RA population. About 1 in 7 patients with RA may not have the necessary skills to become involved in making decisions regarding their personal health. Rheumatologists should be aware of the low health literacy levels of patients with RA and should consider identifying patients at risk of low health literacy.

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