Date of Award


Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)


Physician Assistant Studies


Arthritis; Undifferentiated Connective Tissue Disease; Undifferentiated Systemic Rheumatic Disease; Inflammatory Joint Disease; Disease Modifying Anti-Rheumatic Drugs; hydroxychloroquine


Undifferentiated connective tissue disease (UCTD) was first defined by Leroy over 30 years ago. UCTD is described as an autoimmune disease which presents similarly to other rheumatic diseases but fails to meet laboratory requirements which indicate a specific disease such as rheumatoid arthritis, systemic lupus erythematous, Sjogren's or scleroderma. Common signs and symptoms manifested by patients with UCTD include arthralgias, myalgias, fatigue, fever, Raynaud’s phenomenon and sicca like symptoms in addition to having a positive antinuclear antibody (ANA) test. Often patients with these symptoms are referred to rheumatology. Unfortunately, there is a shortage of rheumatology providers across the nation. Although patients with UCTD have limited access to rheumatologists, there may be room for primary care providers to safely and adequately treat their symptoms with the use of disease modifying antirheumatic drugs (DMARDs) such as hydroxychloroquine. Evidence exists from recent studies that support the use of DMARDs, NSAIDs and low dose corticosteroids in UCTD patients to improve arthralgias, myalgias, fever, and functional limitations. Although the research indicates that the majority of rheumatologists and primary care providers feel UCTD patients should be referred to rheumatology, there is some evidence that primary care providers can also initiate and manage the treatment of UCTD patients. In the absence of rheumatology, primary care providers familiar with using DMARDs such as hydroxychloroquine can safely and effectively provide treatment for these patients.