“Watchful waiting” or intervention?

The pathogenesis of rheumatoid arthritis (RA) begins years before clinical manifestation, but not all patients with joint pain develop RA. Since the primary care physician or internist’s office is usually the first point of contact for patients with arthralgia, this level of care plays a crucial role in early detection and triage. Today, there is a robust evidence base and tools derived from it that provide guidance for optimal decision-making. These include, among others, the EULAR/ACR risk stratification criteria published in 2025.