Five hundred patients with adult rheumatoid arthritis followed for more than 6 years were studied to determine the clinical features presenting on the first visit which were associated with a poor end result. Sustained disease led to the greatest disability, and features present on the first visit suggesting the development of sustained disease were (1) long duration of active disease, (2) severe disease, and (3) the presence in the serum of the rheumatoid factor. Onset early in adult life led to a poor prognosis. Males fared no better than females in this group of patients. By their presence or absence, none of the following clinical features influenced the ultimate outcome: symmetrical involvement, exacerbation or remission early in the course, pain, stiffness, fever, or anemia.
Ragan C, Farrington E. The Clinical Features of Rheumatoid Arthritis: Prognostic Indices. JAMA. 1962;181(8):663–667. doi:10.1001/jama.1962.03050340001001
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