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VIII.12 - Arthritis (Rheumatoid)

from Part VIII - Major Human Diseases Past and Present

Published online by Cambridge University Press:  28 March 2008

Kenneth F. Kiple
Affiliation:
Bowling Green State University, Ohio
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Summary

Rheumatoid arthritis, the major crippling illness among chronic rheumatic disorders, is a systemic disease that affects many joints with an inflammatory reaction lasting months or years. Frequently, the small joints of the hands and feet are affected first, although often the larger peripheral joints of the wrists, hips, knees, elbows, and shoulders are involved as well. Some remissions do occur, but the illness progresses to produce damage and deformity. There is no known etiology.

In 1961, the American Rheumatism Association developed a set of eight diagnostic criteria for rheumatoid arthritis suitable for epidemiological surveys. They are as follows:

1. Morning stiffness

2. Pain on motion or tenderness in at least one joint

3. Swelling (soft tissue) of at least one joint

4. Swelling of at least one other joint

5. Symmetrical joint swelling

6. Nodules under the skin, typically on the surface of muscles that extend or stretch the limbs

7. Observable changes identified by X-rays, typically erosions of bone

8. Positive serologic test for rheumatoid factor

In a given patient, a definite diagnosis of rheumatoid arthritis would depend on the presence of at least five of these criteria and the absence of evidence for other rheumatic conditions.

Distribution and Incidence

When using the above definition, a number of researchers have indicated that rheumatoid arthritis is worldwide, affecting all ethnic groups. A summary of prevalence data in rheumatoid arthritis has been provided by P. D. Utsinger, N. J. Zvaifler, and E. G. Ehrlich (1985). Fifteen studies were cited from countries such as the United States, United Kingdom, Finland, Puerto Rico, Canada, Japan, Bulgaria, and Jamaica.

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Chapter
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Publisher: Cambridge University Press
Print publication year: 1993

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References

Appelbloom, T., et al. 1981. Rubens and the question of the antiquity of rheumatoid arthritis. Journal of the American Medical Association 245.Google Scholar
Badui, E., et al. 1987. El corazón y la arthritis reumatoide. Estudio prospective de 100 casos. Archivos del Institute de Cardiologia de Mexico 57.Google Scholar
Buchanan, W. W., and Murdoch, R. M.. 1979. Hypothesis: That rheumatoid arthritis will disappear. Journal of Rheumatology 6.Google ScholarPubMed
Caughey, D. E. 1974. The arthritis of Constantine IX. Annals of the Rheumatic Diseases 33.CrossRefGoogle ScholarPubMed
Garrod, A. B. 1859. The nature and treatment of gout and rheumatic gout. London.Google Scholar
Klepinger, L. 1979. Paleopathological evidence for the evolution of rheumatoid arthritis. American Journal of Physical Anthropology 50.CrossRefGoogle Scholar
May, W. P. 1897. Rheumatoid arthritis (osteitis deformans) affecting bones 5,500 years old. British Medical Journal 2.CrossRefGoogle Scholar
Ortner, D., and Utermohle, C. S.. 1981. Polyarticular inflammatory arthritis in a pre-Columbian skeleton from Kodiak Island, Alaska. American Journal of Physical Anthropology 56.CrossRefGoogle Scholar
Rogers, J., Dieppe, P., and Watt, I.. 1981. Arthritis in Saxon and medieval skeletons. British Medical Journal 283.CrossRefGoogle Scholar
Rothschild, B. M., Woods, R. J., and Turner, K.. 1987. New World origins of rheumatoid arthritis (abstr). Arthritis and Rheumatism 30 (Suppl.) S61: B29.Google Scholar
Short, C. L. 1974. The antiquity of rheumatoid arthritis. Arthritis and Rheumatism 17.CrossRefGoogle ScholarPubMed
Snorrason, E. 1952. Landré-Deauvais and his goutte asthenique primative. Acta Medica Scandinavica 142 (Suppl.): 115–18.CrossRefGoogle Scholar
Thould, A. K., and Thould, B. T.. 1983. Arthritis in Roman Britain. British Medical Journal 287.CrossRefGoogle ScholarPubMed
Utsinger, P. D., Zvaifler, N. J., and Ehrlich, E. G., eds. 1985. Rheumatoid arthritis. Philadelphia.Google Scholar

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