Osteo-arthrosis and disk degeneration in an urban population.

This study of osteo-arthrosis, or degenerative joint disease, is based on the same survey material as the corresponding paper on rheumatoid arthritis (Kellgren and Lawrence, 1956). A one-in-ten random sample of the population aged 55-64 years in the Lancashire town of Leigh was studied clinically, radiologically, and serologically for all forms of arthritis. After a detailed clinical examination of the joints, routine x rays were taken of the hands, feet, pelvis, knees, and cervical and lumbar spine, and a blood sample was taken for the sheep cell agglutination test (SCAT). The clinical and radiological part of the survey was 79 per cent. complete. In a previous survey of rheumatic complaints made in the town of Leigh in 1949-50, osteo-arthrosis was diagnosed on clinical grounds more frequently than any other form of rheumatism (Kellgren, Lawrence, and Aitken-Swan, 1953). The prevalence of complaints attributable to osteo-arthrosis was exceptionally high in females over 50 years of age, and in this sex was more often polyarticular and was less closely associated with trauma or occupation than in males. A separate study of patients seen at the University Rheumatism Clinic had shown that women frequently suffer from a polyarticular form of osteo-arthrosis which has a distinct symptomatology, course, and pattern of joint involvement. This condition has been described as "primary generalized osteo-arthritis" (Kellgren and Moore, 1952). The present study was designed to obtain more precise information about this condition, and to investigate causative factors in osteo-arthrosis in general. For details of sampling and for the method of conducting the survey, the paper on rheumatoid arthritis should be consulted. At the clinical examination all persons seen were given a grading for rheumatoid arthritis and for local and generalized osteo-arthrosis. The x rays were later read by two observers in consultation. Problems of observer