Diagnostic Delay in Chronic Inflammatory Rheumatic Diseases Presented to the Tertiary Care Rheumatology Unit in PIMS

Objective: To quantify the therapeutic and diagnostic delays among patients with CIRDs in Pakistan. Study Design and Setting: Cross sectional study. PIMS Hospital Islamabad Rheumatology OPD. Duration 8th June 2025 to 8th September 2025. Methodology: This cross-sectional study comprised 220 patients. Informed consent was obtained; demographic details like age and sex were noted. All Patients previously diagnosed with conditions such as rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, or similar diseases were selected from various rheumatology clinics and departments over six months. Data collection was done using a structured face-to-face interview which included data on demographic information, age of symptom onset, consultation times, and treatment commencement, dividing delays into diagnostic and therapeutic categories. For the analysis in SPSS v21, Shapiro–Wilk, Chi-square, and Fisher’s Exact Test were performed, and the results were presented as the median for continuous variables and percentages for categorical data. A p-value = 0.05 was taken as statistically significant. Results: A total of 220 participants were included in this study. Among the 220 patients, 40.5% had diagnostic delay exceeded 18 months with only 6.4% diagnosed within 6 months. Patients who visited homeopaths had the highest delay rate (56.1%). Psoriatic arthritis (71.4%) and ankylosing spondylitis (53.8%) had longest delays. Joint pain led to early referral in 54.6%, whereas atypical symptoms caused prolonged delays. Conclusions: The findings of this study revealed that both diagnostic and therapeutic delays are common in CIRDs in Pakistan, often caused by multiple reasons before reaching a rheumatologist and referral system inefficiencies