Historical perspective on the etiology of rheumatoid arthritis

Abstract

Contributions of historical analyses to the development of a cogent etiologic theory of rheumatoid arthritis (RA) have been limited to date. In this article, the authors analyze this literature with respect to the types and conclusions of the research that has been conducted, present the major points of evidence and conclusions that have been drawn, and trace the evolution of 3 historical theories of RA. The authors combine a comprehensive overview of paintings and paleopathological investigations with consideration of contemporary immunologic and genetic studies.

Figure 1

(a) Peter Paul Rubens’ The Three Graces, (b) closeup of the left-most figure’s hand, (c) patient with similar pattern of RA damage.

Figure 1

(a) Peter Paul Rubens’ The Three Graces, (b) closeup of the left-most figure’s hand, (c) patient with similar pattern of RA damage.

Figure 1

(a) Peter Paul Rubens’ The Three Graces, (b) closeup of the left-most figure’s hand, (c) patient with similar pattern of RA damage.

Figure 2

(a) An anonymous Flemish painter’s depiction of The Temptation of St. Anthony, (b) the beggar, (c) close-up of the beggar’s deformed hand showing slight ulnar deviation, finger contractures, and wrist luxation. From Dequeker J, Rico H. Rheumatoid Arthritis-like Deformities in an Early 16^th-Century Painting of the Flemish-Dutch School. JAMA 1992;265(2):249–51, with permission. (d & e) patient with a similar pattern of RA damage.

Figure 2

(a) An anonymous Flemish painter’s depiction of The Temptation of St. Anthony, (b) the beggar, (c) close-up of the beggar’s deformed hand showing slight ulnar deviation, finger contractures, and wrist luxation. From Dequeker J, Rico H. Rheumatoid Arthritis-like Deformities in an Early 16^th-Century Painting of the Flemish-Dutch School. JAMA 1992;265(2):249–51, with permission. (d & e) patient with a similar pattern of RA damage.

Figure 2

(a) An anonymous Flemish painter’s depiction of The Temptation of St. Anthony, (b) the beggar, (c) close-up of the beggar’s deformed hand showing slight ulnar deviation, finger contractures, and wrist luxation. From Dequeker J, Rico H. Rheumatoid Arthritis-like Deformities in an Early 16^th-Century Painting of the Flemish-Dutch School. JAMA 1992;265(2):249–51, with permission. (d & e) patient with a similar pattern of RA damage.

Figure 2

(a) An anonymous Flemish painter’s depiction of The Temptation of St. Anthony, (b) the beggar, (c) close-up of the beggar’s deformed hand showing slight ulnar deviation, finger contractures, and wrist luxation. From Dequeker J, Rico H. Rheumatoid Arthritis-like Deformities in an Early 16^th-Century Painting of the Flemish-Dutch School. JAMA 1992;265(2):249–51, with permission. (d & e) patient with a similar pattern of RA damage.

Figure 2

(a) An anonymous Flemish painter’s depiction of The Temptation of St. Anthony, (b) the beggar, (c) close-up of the beggar’s deformed hand showing slight ulnar deviation, finger contractures, and wrist luxation. From Dequeker J, Rico H. Rheumatoid Arthritis-like Deformities in an Early 16^th-Century Painting of the Flemish-Dutch School. JAMA 1992;265(2):249–51, with permission. (d & e) patient with a similar pattern of RA damage.

Figure 3

Right hand of skeleton found by Arcini, showing ulnar deviation and damage of the second finger indicative of RA. From Arcini, C. Rheumatoid Arthritis – rare reality as recovered among Scanian skeletal remains from Viking and Medieval times. Sydsvenska Medicinhistoriska Sallskapet 1992;18:11–21, with permission.