Poster Presentations

Background: The workload at rheumatology clinics have been growing relentlessly and an audit on new referrals helps to identify referral behavior of primary care doctors improvement can be done by providing further training. Objective: To cases clinic during Covid-19 pandemic 2020 with misdiagnosis for future training purpose. Methods: This was a retrospective study. electronic medical records all Hospital Sultan Ismail from 1 st January 28 th February 2021 were reviewed. variety cases, reason final diagnoses identified analyzed. Results: There total 462 referred throughout the 14 months pandemic. Majority them are diagnosed rheumatoid arthritis (RA, 115/462) followed systemic lupus erythematosus (SLE, 93/462), psoriatic (PSA,82/462), gout (26/462), osteoarthritis (23/462), soft tissue rheumatism (14/462), sclerosis (SSc, 11/462), fibromyalgia (8/462), ankylosing spondylitis (AS, 8/462), sjogren syndrome vasculitis (7/462), mixed connective disease (MCTD, 7/462) miscellaneous (23/462). 17 out as unlikely rheumatic diseases. 20 pending awaiting diagnosis. 96 highest nodal (18/96) (17/96), (14/96), RA (12/96), PSA (9/96), (4/96), (3/96), SLE polymyositis (2/96), AS (2/96) others (8/96 : DISH, hypermobility syndrome, RS3PE degenerative disc disease, idiopathic uveitis, graft versus host JIA, MCTD traumatic arthritis). Conclusion: Nodal great mimicker inflammatory if wrongly will induce unnessary anxiety or wrong treatment. More needed improve clinical skills amongst doctors.