Rheumatoid Arthritis

Abstract

Rheumatoid arthritis is a fairly common systemic disease of multifarious and obscure etiologies, affecting primarily the synovial membranes of the joints in the appendicular and axial skeleton. It has a notorious predilection for the small joints of the hands and feet although the large joints of the wrists, knees, elbows, shoulders, and sternum are not exempted. The involvement is typically polyarticular and symmetrical. In the spine, the cervical vertebrae, particularly the atlantoaxial joint, are most commonly involved, and cervical involvement may or may not be accompanied by appendicular arthritis (Bland (1967) Rheumatoid arthritis of the cervical spine. Bull Rheum Dis 18:471–476). The prevalence rate estimated using the 1958 criteria of the American Rheumatism Association for definite rheumatoid arthritis varies from 0.3% to 1.5% (Wolfe (1968) The epidemiology of rheumatoid arthritis: review. Bull Rheum Dis 19:518–523), and limited population studies performed in Europe and North America have indicated the incidence to range from 1% to 3%. A recent limited population study performed in Seoul has shown a prevalence rate of 1.5% (Bae SC (2005), personal communication). Women are affected two to three times more frequently than men. Adults in any age may be affected, with the highest incidence occurring between the fifth and sixth decades of life.