EARLY ARTHRITIS IN POPULATION STUDIES
Research concerning early arthritis and early rheumatoid arthritis (RA) may be thought to have begun in population-based studies in the late 1950s to late 1960s. These studies indicated that the majority of people who had clinical findings of RA had no evidence of disease 3–5 years later1, and that only about 25%–30% of people in a population who met criteria for RA had rheumatoid factor. These observations were thought for many years to apply to RA as seen in rheumatology clinical settings. However, they appear to apply to a different population, as many of those identified in these epidemiologic studies likely never saw a physician, and their symptoms resolved spontaneously. Therefore, instead of improving understanding of clinical RA, these early findings may have contributed to an underestimation of clinical RA until the severity of longterm outcomes of patients who were seen in rheumatology settings were recognized in the 1980s and later2–4, on the basis of longitudinal followup of clinical cohorts for 10–40 years.
THE MOVEMENT TOWARD EARLY ARTHRITIS CLINICS
Emery and Gough5 pointed out that RA is the most common cause of potentially treatable disability in Western countries, based on recognition of longterm severity of clinical RA2–4. At that time, general …
Address correspondence to Dr. T. Sokka, Arkisto/Tutkijat, Jyvaskyla Central Hospital, 40620 Jyvaskyla, Finland. E-mail: tuulikki.sokka{at}ksshp.fi; tuulikki_sokka{at}hotmail.com