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May 1958

X-Ray Manifestations of Peptic Ulceration During Corticosteroid Therapy of Rheumatoid Arthritis

Author Affiliations

Bethesda, Md.

From the Diagnostic X-Ray Department, the Clinical Center, National Institutes of Health; Chief, Diagnostic X-Ray Department, the Clinical Center (Dr. Hilbish); Senior Investigator, National Institute of Arthritis and Metabolic Diseases (Dr. Black).

AMA Arch Intern Med. 1958;101(5):932-942. doi:10.1001/archinte.1958.00260170088012

Peptic ulcers have been known to occur in the human race for many decades and indeed are not unknown in animals, such as dogs, cows, sheep, and, rarely, rats.4 Furthermore, correlations have been shown between the incidence of peptic ulcers and such things as population density and severe stress. It has been said that between 5% and 10% of our population can expect to have an ulcer at some point during their lifetime. The occurrence of such ulcers has come to be associated with a certain clinical syndrome of abdominal pain relieved by food and antacids, abdominal tenderness, and definite radiographic abnormalities which are demonstrable in most cases.

The advent in 1949 of the use of cortisone and corticotropin (ACTH) in the treatment of rheumatic disease 5 and more recently of synthetic analogues, such as prednisone and prednisolone,3 began an era of a new sort of peptic ulcer—one