Rheumatoid Arthritis in a New England Town

Abstract

Examinations for rheumatoid arthritis were made on 4626 persons comprising 77 per cent of the adult population of Sudbury, Massachusetts. With the use of American Rheumatism Association criteria, 3.8 per cent of females and 1.3 per cent of males were rated as having probable or definite rheumatoid arthritis; with the New York clinical criteria, corresponding rates were 0.55 and 0.14 per cent. Although both criteria agreed that rheumatoid arthritis is uncommon below the age of 45 years, they disagreed widely on its frequency in the whole community. This disparity resulted from the high frequency of individual joint symptoms and signs, difficulties in interpreting minimal soft-tissue swelling and the high prevalence of degenerative joint disease. The criteria of the American Rheumatism Association, based on a point system related to individual symptoms, were more affected by these factors than the New York criteria, which required involvement of three joint groups. Rheumatoid arthritis, defined as a chronic polyarthritis, was thus much less frequent than previous population studies in this country had implied.