rome and Arthritis--Rheumatoid

In a Sidonian sarcophagus, from the Late Antique/early Christian period, skeletal remains of two persons were found. One of them, male, 30-50 years old, was found almost completely ankylosed, with highly osteoporotic bones and prominent erosion of joint surfaces. We diagnosed rheumatoid arthritis based on the eroded odontoid process, mandibular condyles, distal humerus, proximal and distal ulna, as well ankylosed hand and foot bones. Despite the fact that ankyloses of vertebrae and sacroiliac joint could point towards ankylosing spondylitis, the lack of typical vertebral ankyloses and new bone formation led to exclusion. In a practical sense, due to the advanced stage of the disease, the man was fixed in the supine position, on the left, with his head turned to the right. Apparently, he could not move and had problems with chewing and breathing. But, the high standard of provided healthcare probably enabled him to survive in advanced stages of the disease. This case shed light on the antiquity of the disease, its medical, and social context and provided the example of most extreme osteological changes reported in the paleopathological and medical literature.

Topics: Adult; Archaeology; Arthritis, Rheumatoid; Disease Progression; Elbow Joint; History, Ancient; Humans; Male; Middle Aged; Rheumatology; Rome; Sacroiliac Joint; Spine; Spondylitis, Ankylosing

To compare the diagnostic properties of the Rome 1961 criteria for active rheumatoid arthritis (RA) and the American College of Rheumatology (ACR; formerly, the American Rheumatism Association) 1987 criteria for RA with regard to their ability to classify, diagnose, and predict outcome in RA.. Analysis of cross-sectional and longitudinal data from repeated health examinations and review of clinical records of 3,509 Pima Indians followed up from January 1966 to December 1990.. The ACR 1987 criteria identified approximately 50% of the cases identified by the Rome 1961 criteria, in both cross-sectional and longitudinal analyses. The ACR 1987 criteria were better predictors of subsequent development of a clinically supported diagnosis and treatment with slow-acting antirheumatic drugs (both P < 0.001), but were less sensitive than the Rome 1961 criteria for detecting cases for which there already was a clinically supported diagnosis (P < 0.001).. In a population-based analysis, the ACR 1987 criteria are less sensitive for detecting clinical disease, but predict a clinically more severe prognosis, compared with the Rome 1961 criteria. The sensitivity of both sets of criteria to identify clinical disease is improved if multiple examinations or inactive disease are taken into account.

Topics: Arizona; Arthritis, Rheumatoid; Cross-Sectional Studies; Female; Humans; Indians, North American; Longitudinal Studies; Male; Radiography; ROC Curve; Rome; Sensitivity and Specificity; United States

Examinations of 5021 subjects (2779 females and 2242 males) were carried out with a view to rheumatoid arthritis. En masse examinations of the population over the age of 20 were carried out in eight villages of South Bulgaria. Making use of the Roman diagnostic criteria, rheumatoid arthritis--probable form, was found in 1.47 per cent of the males and 1.40 per cent of the females (mean for both sexes-1.43%), confirmed form (including the classical) in 0.80 per cent of the males and 1.12 per cent of the females (a total of 0.98% for both sexes). With two positive New York diagnostic criteria are 1.12 per cent of the males and 1.30 per cent of the females (a total of 1.21% for both sexes). With three and four positive New York criteria are 0.45 per cent of the males and 0.76 per cent of the females (a total of 0.62% for both sexes). Only 60 per cent of the subjects with confirmed (including the classical) rheumatoid arthritis are with three or four New York diagnostic criteria. The Roman diagnostic criteria define sometimes subjects with polyarthritis as patients with rheumatoid arthritis, whereas New York criteria fail to detect the cases with rheumatoid arthritis with asymmetric joint involvement.

Topics: Adult; Age Factors; Aged; Arthritis, Rheumatoid; Bulgaria; Female; Humans; Male; Middle Aged; New York City; Rome; Rural Population; Sex Factors

Topics: Adolescent; Adult; Aged; Arthritis, Rheumatoid; Diagnosis, Differential; Epidemiologic Methods; Female; Humans; Indians, North American; Male; Mass Screening; Middle Aged; New York City; Radiography; Rheumatoid Factor; Rome; Sex Factors; Statistics as Topic