Intended for healthcare professionals

Practice A Patient’s Journey

Rheumatoid arthritis

BMJ 2010; 341 doi: (Published 31 December 2010) Cite this as: BMJ 2010;341:c7095
  1. Ailsa M Bosworth, patient, and chief executive of National Rheumatoid Arthritis Society1,
  2. Alan Steuer, consultant rheumatologist 2
  1. 1National Rheumatoid Arthritis Society, Westacott Business Centre, Maidenhead SL6 3RT, UK
  2. 2Wexham Park Hospital, Wexham, Slough SL2 4HL, UK
  1. Correspondence to: A Bosworth Ailsa{at}
  • Accepted 30 November 2010

Ailsa Bosworth was about 30 years old when she was diagnosed with seronegative rheumatoid arthritis. She describes her journey with the disease that led her to found a national charity, the National Rheumatoid Arthritis Society

My father had ankylosing spondylitis with active peripheral arthritis and iritis and was severely ill all his life. He died early from a stroke at age 62. Despite this family history, when I started to experience symptoms of a painful, swollen knee, it didn’t occur to me that I might have inflammatory arthritis. My parents’ generation kept their health problems private and didn’t really share their difficulties with their children. So although I was aware my father had something called spondylitis and was taking various drugs, I didn’t really understand what this meant, what caused it, or what the future might hold for him, or me.

The diagnosis

Rheumatoid arthritis is painful and disabling. It is not well understood by the general public, who hear the word arthritis and interpret it as osteoarthritis, a quite different disease. This is a source of great irritation to people with rheumatoid arthritis. A major cause of delay in diagnosis is people’s failure to recognise that their symptoms indicate potentially serious and incurable illness. This is probably why it took nine months before my boss forced me to go and see a general practitioner, by which time I could barely walk. The general practitioner referred me immediately to a rheumatologist and rheumatoid arthritis was diagnosed straight away. I found myself in hospital having my knee aspirated and injected with steroid, and my whole leg was put into plaster. As soon as the cast came off and I started walking around again, the knee filled up. I can’t now remember how many times it was aspirated.

I had my daughter in 1982, …

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