ReviewCureus2026
Epistemic Injustice in Rheumatoid Arthritis Care: A Narrative Review of Invisible Suffering, Ageism, and Treatment Delay.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Despite advances in disease-modifying therapies and treat-to-target strategies, many patients with rheumatoid arthritis (RA) continue to experience persistent pain, fatigue, and functional impairment. These symptoms are particularly common among older adults and are frequently under-recognized in clinical practice. This study examines RA care through the lens of epistemic injustice to explore how patients' experiential knowledge is interpreted, valued, or discounted, and how these processes contribute to treatment delay in aging societies. We conducted a narrative review of peer-reviewed literature addressing patient experiences, diagnostic and treatment delays, aging-related factors, and epistemic concepts relevant to RA care. Publications were identified through targeted database searches and citation tracking across rheumatology, social medicine, and medical ethics. Studies were examined conceptually to identify patterns of testimonial and hermeneutical injustice operating across the RA care continuum. Across the included literature, patients' reports of pain, fatigue, and functional decline were frequently afforded reduced credibility when objective inflammatory markers appeared controlled, reflecting testimonial injustice. Hermeneutical injustice was evident when patients, particularly older and socially isolated individuals, lacked interpretive frameworks to recognize symptoms as pathological rather than age-related. These intersecting epistemic failures operated both before and after diagnosis, contributing to delayed help-seeking, delayed referral, and delayed treatment adjustment despite ongoing suffering. Treatment delay in RA cannot be fully explained by structural or biomedical factors alone. Epistemic injustice plays a critical role in shaping symptom interpretation and clinical decision-making, particularly in older adults. Addressing these epistemic dimensions by integrating patient testimony and patient-reported outcomes more meaningfully into care may promote timelier, more equitable, and more responsive RA management in aging populations. This review uniquely reframes treatment delay in RA as an epistemic problem, demonstrating how ageism and social isolation systematically distort symptom interpretation beyond structural or biomedical explanations.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.