Rheumatoid arthritis (RA) is a systemic, chronic inflammatory disease of unknown cause. Approximately 5–10% of patients with RA have an enlarged spleen on manual palpation1 or on isotope scanning.2

We measured the size of the spleen in 50 patients with RA (nine men, 41 women; average age 55.8 years (range 25–78)) and 14 healthy control subjects (no men, 14 women; average age 47.8 years (range 25–80)) by abdominal ultrasonography (Aloka, Japan). This examination was done by one skilful examiner (TD) in all cases, and comparisons were made with clinical profile and disease activity. The patients with a diagnosis of Felty's syndrome, categorised as the triad, RA, leucopenia, and splenomegaly, and patients with complications of any viral or bacterial infections were excluded from this study. Mean (SD) disease duration was 6.2 (6.6) years. The disease stage was I (13 patients), II (11), III (nine), IV (17) and the functional class was I (seven patients), II (40), III (three), IV (0), assigned according to Steinbrocker criteria.3 The following treatment …