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Annual incidence of inflammatory joint diseases in a population based study in southern Sweden
Linköping University, Department of Clinical and Experimental Medicine, Rheumatology . Linköping University, Faculty of Health Sciences.
Department of Internal Medicine, Växjö Central Hospital, Växjö, Sweden.
Rheumatism Foundation Hospital, Heinola, Finland.
Linköping University, Department of Clinical and Experimental Medicine, Rheumatology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Rheumatology in Östergötland.ORCID iD: 0000-0002-0153-9249
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2002 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, Vol. 61, 911-915 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To estimate the annual incidence of inflammatory joint diseases in a population based prospective referral study in an adult population in Kronoberg County in southern Sweden.

Methods: The patients were referred from primary healthcare centres to the rheumatology department in Växjö Central Hospital or to the one private rheumatologist in Växjö participating in the study. Additionally, the hospital records for patients with joint aspirates during the inclusion period were checked. The patients were registered as incident cases if the onset of the joint inflammation was between 1 May 1999 and 1 May 2000. A systematic follow up of incoming referrals was conducted up to 31 January 2001. Children under the age of 16 and patients with septic arthritis, crystal arthropathies, and osteoarthritis were excluded from the study.

Results: A total of 151 new cases with inflammatory joint diseases were identified during one year, corresponding to a total annual incidence of 115/100 000. Of these, 31 patients (21%) had rheumatoid arthritis, the annual incidence being 24/100 000 (for women 29/100 000, and for men 18/100 000). Reactive arthritis was diagnosed in 37 patients (24%, annual incidence 28/100 000) and 54 patients had undifferentiated arthritis (36%, annual incidence 41/100 000). Eleven patients presented with psoriatic arthritis (7%, annual incidence 8/100 000). The incidence of Lyme arthritis was small in this non-endemic area, and the incidence of sarcoid arthritis corresponded to that in earlier studies.

Conclusion: This is the first prospective population based annual incidence study of early arthritis in Sweden. In this population, 36% of the incident cases had undifferentiated arthritis, whereas rheumatoid arthritis and reactive arthritis accounted for 45% of the cases. The incidence figures compare well with figures reported from other countries.

Place, publisher, year, edition, pages
2002. Vol. 61, 911-915 p.
Keyword [en]
incidence, epidemiology, rheumatoid arthritis, spondyloarthropathy
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-13709DOI: 10.1136/ard.61.10.911OAI: oai:DiVA.org:liu-13709DiVA: diva2:21190
Available from: 2003-12-16 Created: 2003-12-16 Last updated: 2015-08-31
In thesis
1. A population-based study on early arthritis in southern Sweden: Incidence, preceding infections, diagnostic markers and economic burden
Open this publication in new window or tab >>A population-based study on early arthritis in southern Sweden: Incidence, preceding infections, diagnostic markers and economic burden
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The total annual incidence of arthritis in this prospective cross-sectional study on adults was 115/100 000. The annual incidence of rheumatoid arthritis (RA) was 24/100 000, 29/100 000 for women, and 18/100 000 for men. For reactive arthritis (ReA) the annual incidence was slightly higher, 28/100 000, and for undifferentiated arthritis 41/100 000. The annual incidence of Lyme disease and sarcoid arthritis was low. The annual incidence of arthritis in this study compares well with findings in earlier reports from both registers and case review studies. Almost 50% of the patients in the series of 71 patients with arthritis of less than 3 months’ duration had a preceding infection. Campylobacter jejuni ReA dominated the enteric ReA group. We found only a few patients with preceding Chl. trachomatis, Chl. pneumoniae, Borrelia burgdorferi or parvovirus B19 infections. The arthritis patients with a preceding infection went into remission more often than the patients without a preceding infection. The disease specificity of anti-CCP antibodies for RA was high, 96%, confirming earlier results. Anti-CCP antibodies differentiated RA from other arthritides. Several patients in the different diagnosis groups had raised serum COMP levels, indicating cartilage involvement very early in the disease, even in mild and self-limiting disease with good prognosis. The economic burden of early joint inflammation was found to be considerable already during the first few months of the arthritis irrespective of diagnosis. Surprisingly, patients with ReA generated almost as high costs as patients with RA during thefirst few months of the disease, even though most of the ReA patients had a relatively mild disease. Sick leave accounted for about 50% of the costs. The distribution of costs in the different patient groups was skewed. The median cost per patient for the group of patients with RA was US$4385, for ReA US$4085, for other types of specified arthritis US$3361, and for undifferentiated arthritis US$1482. This underlines the necessity of quick referral and therapy, not only to decrease the inflammation and prevent functional impairment, but also to decrease the costs of early arthritis.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2003. 100 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 824
Keyword
Arthritis diagnosis, arthritis economics, Biological markers blood, Extracellular matrix proteins blood, Cost of illness
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-5225 (URN)91-7373-506-X (ISBN)
Public defence
2003-11-21, Elsa Brändströmsalen, Campus US, Linköpings universitet, Linköping, 13:00 (English)
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Available from: 2003-12-16 Created: 2003-12-16 Last updated: 2015-08-31Bibliographically approved

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Söderlin, MariaSkogh, Thomas

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