Summary
A total of 300 consecutive patients referred to a tertiary-care center and fulfilling the American Rheumatism Association criteria for definite-classical rheumatoid arthritis, (with a mean disease-duration of 10.3±9 years) were studied by structured interview and medical record review. The type of onset (rapid or insidious), type of joint involved (small, medium, large or combined joints) and pattern of joint involvement (monarticular, pauciarticular or polyarticular) at onset, and the interval between the first symptom and development of established disease were determined from the interview (based on the patient's memory). The onset was rapid in 46%. Initial involvement occurred in small joints in 31%, medium joints in 16%, large joints in 28% and combined sites in 25%. The pattern of joint involvement at onset was monarticular in 21%, pauciarticular in 44% and polyarticular in 35%. The time for disease to become established was less than 1 month in 25%, 1–6 months in 35%, 6–12 months in 14% and over 1 year in 26%. The monarticular pattern of onset was associated with slower development of established disease than the other patterns of joint involvement; polyarticular disease tended to be associated with polyarticular onset; involvement of large joints was associated with pauciarticular onset.
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References
Fleming A, Crown JM, Corbett M (1976) Early rheumatoid disease. I. Onset. Ann Rheum Dis 35:357–360
Fleming A, Benn RT, Corbett M, Wood PHN (1976) Early rheumatiod disease. II. Patterns of joint involvement. Ann Rheum Dis 35:361–364
Jacoby RK, Jayson MIV, Cosh JA (1973) Onset, early stages and prognosis of rheumatiod arthritis: A clinical study of 100 patients with 11-year follow-up. Br Med J 2:96–100
Ragan C, Farrington BS (1962) The clinical features of rheumatoid arthritis: prognostic indices. JAMA 181:663–667
Luukkaine R, Isomaki H, Kajander A (1983) Prognostic value of the type of onset of rheumatoid arthritis. Ann Rheum Dis 42:274–275
Wawrzynska-Pagowska J, Brzezinska B, Brzozowska M, Graff T, Juszczyk T, Michalski J, Pakula A, Piotrowska D, Wojcik-Scislowska M (1970) Observations on the symptoms and signs of early rheumatoid arthritis in a prospective study. Acta Rheum Scand 16:99–105
Short CL, Bauer W, Raynolds WE (1957) Rheumatoid arthritis: A definition of the disease and a clinical description based on a numerical study of 293 patients and controls. Cambridge, Harvard University Press
Fallahi S, Halla J, Hardin JG (1983) A reassessment of the nature of onset of rheumatoid arthritis. Clin Res 31:650A
Harris E (1985) Rheumatoid arthritis-the clinical spectrum. In: Kelly W, Harris E, Ruddy S, Sledge C (eds) Textbook of rheumatology. Philadelphia, Saunders, pp 915–950
Resnick D, Niwayama G (1981) Rheumatoid arthritis. In: Resnick D, Niwayama G (eds) Diagnosis of bone and joint disorders. Philadelphia, Saunders, pp 906–1007
Bland JH, Eddy WM (1968) Hemiplegia and rheumatoid hemiarthritis. Arthritis Rheum 11:72–80
Glick E (1967) Asymmetrical rheumatiod arthritis after poliomyelitis. Br Med J 3:26–29
Ropes M (1959) Diagnostic criteria for rheumatoid arthritis. 1958 revision. Ann Rheum Dis 18:49–53
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Halla, J.T., Hardin, J.G. & Fallahi, S. The nature of the onset of rheumatoid arthritis: a reassessment. Rheumatol Int 7, 169–171 (1987). https://doi.org/10.1007/BF00270365
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DOI: https://doi.org/10.1007/BF00270365