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  1. Richard Lehman
  1. Department of Primary Care, University of Oxford; Oxford, UK

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    Rheumatoid arthritis (RA) is the decidedly odd name we give to a disease we still don’t understand. An ancient Greek faced with the word “rheumatology” would guess it had something to do with fluid dynamics and Archimedes; but over the centuries “rheum” (that which flows) became identified with mucus, and “rheumatics” with the aches and pains that are associated with a flowing nose. Finally, in 1859, A B Garrod tried to describe a new disease which wasn’t gout or what was then called rheumatism: “Although unwilling to add to the number of names… perhaps Rheumatoid Arthritis would answer the object.” Well, we can all agree about the “arthritis” part, and it is characteristic of RA that it affects more than 1 joint from the start. In fact a French follow-up study of the outcome of early monoarthritis (J Rheumatol 2007;34:2351–7) found that nobody in their series of 27 patients who presented with single-joint inflammation went on to develop RA within a median follow-up of 30 months. Recent years have seen a much more aggressive approach …

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