Prognosis in the Rheumatic Diseases

1. Front Matter

   Pages i-xiii

   PDF

2. Introduction

   • J. F. Fries, N. Bellamy

   Pages 1-10

3. Osteoarthritis

   • K. D. Brandt, D. Flusser

   Pages 11-35

4. Rheumatoid arthritis

   • F. Wolfe

   Pages 37-82

5. Juvenile arthritis

   • B. M. Ansell

   Pages 83-96

6. Crystal-associated arthropathies

   • B. T. Emmerson

   Pages 97-131

7. Ankylosing spondylitis

   • P. S. Helliwell, V. Wright

   Pages 133-152

8. Psoriatic arthritis

   • D. D. Gladman

   Pages 153-166

9. Reiter’s syndrome

   • W. F. Kean, D. W. MacPherson

   Pages 167-192

10. Systemic lupus erythematosus

    • R. Roubenoff, M. C. Hochberg

    Pages 193-212

11. Systemic sclerosis (scleroderma)

    • V. D. Steen, T. A. Medsger

    Pages 213-231

12. Polymyositis-dermatomyositis

    • C. V. Oddis, T. A. Medsger

    Pages 233-249

13. Vasculitis

    • F. J. Barbado, J. J. Vázquez, M. Khamashta, G. R. V. Hughes

    Pages 251-267

14. Polymyalgia rheumatica and giant cell arteritis

    • L. A. Healey

    Pages 269-277

15. Arthritis in pregnancy

    • N. Bellamy, R. R. Grigor, R. P. Naden

    Pages 279-319

16. Fibromyalgia

    • F. Wolfe

    Pages 321-332

17. Low back pain

    • I. K. Y. Tsang

    Pages 333-345

18. Prediction of the clinical efficacy of and intolerance to antirheumatic drug therapy

    • P. M. Brooks, W. W. Buchanan

    Pages 347-402

19. Prediction of organ system toxicity with antirheumatic drug therapy

    • W. W. Buchanan, P. M. Brooks

    Pages 403-450

20. New concepts in prognosis of rheumatic diseases for the 1990s

    • T. Pincus

    Pages 451-492

Seer, forecaster, prophet, geomancer, or tout - all predict future events as physicians must. The medical activity is prognosis from the Greek pro (forward) and gnosis (special knowledgeL thus foreknowledge, and the practitioner is the prognosticator, a sobriquet which falls unhappily upon the ear. Like it or not, there is nothing more critical in the management of chronic rheumatic conditions than a reasonably clear picture of what time and disease will bring. The knowledge is so much a part of ordinary medical thinking that we rarely grace it with the label prognosis. But, like so much of "ordinary medical thinking" (an oxymoron, perhaps), quantitative data are very thin and the chestnuts of personal observation and authority figure assertion loom large. Unlike several books I have seen or written, this one on prognosis needs no justification. The entirety of a person's life contributes to and confounds what the future holds. The ingredients include education levet income, support structures such as family, housing, occupation, availability of medical services, diagnosis, treatment, rate of disease progression, age, gender, race, marital status, and others too numerous to mention or too arcane to be recognized. One would think the task of estimating prognosis impossible. And yet there is light on the horizon -we do know a few things such as the effect of high rheumatoid factor titers on the prognosis of RA or the likely outcome of certain kidney lesions in SLE.

• rheumatic diseases

• University of Western Ontario, London, Canada

  Nicholas Bellamy

• Division of Rheumatology, Victoria Hospital, London, Canada

  Nicholas Bellamy

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