Jm. Berthelot et al., The nosology-taxonomy of recent-onset arthritis: The experience of early-arthritis clinics, SEM ARTH RH, 30(5), 2001, pp. 354-365
Objective: To compare the conclusions of studies addressing the outcome of
early-arthritis cohorts.
Methods: The methodologies of previous reports on early-arthritis cohorts w
ere examined, and their results and conclusions were compared.
Results: Thirty-four reports on 23 cohorts of early arthritis were found. T
he methodology was poor in most studies, with numerous inclusion and exclus
ion biases, frequently short follow-up periods, and a lack of precision abo
ut the rationale for diagnosis. However, similar conclusions were reached o
n several points: a large number of cases of early arthritis remained undif
ferentiated and/or resolved spontaneously, about 80% of cases initially cla
ssified as undifferentiated or rheumatoid arthritis retained this diagnosis
during followup, and the incidence of psoriatic arthritis in most studies
was similar (2% to 4%). Conversely, there were striking discrepancies among
studies concerning the frequency of crystal arthropathies (0% to 18%), spo
ndyloarthropathy (1% to 33%) and rheumatoid arthritis (15% to 47%),
Conclusions: There appears to be a lack of agreement among researchers abou
t the nosology and/or taxonomy of many cases of mild arthritis, despite the
existence of classification criteria.
Relevance: Recognition of cultural bias in the diagnosis of early arthritis
could be a prerequisite for the optimization of new sets of criteria for t
he diagnosis of early rheumatoid arthritis and spondyloarthropathy, Semin A
rthritis Rheum 30:354-365. Copyright (C) 2001 by W.B. Saunders Company.