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Rheumatology 2001; 40: 262-266
© 2001 British Society for Rheumatology

A case–control study examining the role of physical trauma in the onset of rheumatoid arthritis

A. W. Al-Allaf, P. A. Sanders, S. A. Ogston1 and J. S. Marks

Department of Rheumatology, Devonshire Royal Hospital, Buxton, Derbyshire SK17 6RX and
1 Department of Public Health, Dundee Teaching Hospital NHS Trust, Dundee DD1 9SY, UK

Objective. To investigate whether physical trauma may precipitate the onset of rheumatoid arthritis (RA).

Method. In a case–control study comparing RA out-patients with controls attending non-rheumatology out-patient clinics, 262 patients and 262 age- and sex-matched controls completed a postal questionnaire or were interviewed about any physical trauma in the 6 months before the onset of their symptoms.

Results. Fifty-five (21%) of the RA patients reported significant physical trauma in the 6 months before the onset of their disease, compared with only 17 (6.5%) of the controls (P<0.00001). A preceding history of physical trauma was significantly more common in RA patients who were seronegative for rheumatoid factor (P=0.03), but was not significantly associated with sex (P=0.78), age (P=0.64), a family history of RA (P=0.07) or type of occupation, defined as manual or sedentary (P=0.6).

Conclusion. Physical trauma in the preceding 6 months is significantly associated with the onset of RA.

KEY WORDS: Rheumatoid arthritis, Physical trauma, Occupation.

Correspondence to: A. W. Al-Allaf, University Department of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK.


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