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Epidemiology of the rheumatic diseases
  1. F Guillemin

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    Eight years after the first edition, this revision reflects the extraordinary growing importance of epidemiology of the rheumatic diseases. The present volume illustrates the complexity of the discipline and its many links with other specialties, particularly with genetics. It makes it very clear that the epidemiology of rheumatic diseases deserves more than a sentence or a section at the beginning of each chapter in textbooks.

    This second edition has been largely rewritten and augmented by new contributions. It expands the scope to new aspects of rheumatology, including syndromes and the particular burden of overall musculoskeletal diseases, which is of major importance at the beginning of the Bone and Joint Decade (BJD).

    The aims are to understand the basic concept of, and specific difficulties related to, the epidemiology of rheumatic diseases. Each chapter has a useful format which describes the methodological difficulties in the disease considered from the standpoint of diagnosis and classification criteria, incidence, prevalence and time trends, and exposure factors classified into genetic and non-genetic, particularly environmental, factors. Minor departures from this scheme are sometimes justified by the particular aspects of some diseases. Chapters are well referenced.

    There is a supplementary thematic index with well organised and comprehensive information. Although up-to-date in the presentation and taxonomy of diseases, the book will probably require periodic revision because of continuous progress in the field, an undertaking which should be encouraged. As a comprehensive worldwide perspective of the rheumatic diseases as currently described in published reports, it has no competitor.

    Because increasing interest from policy makers in rheumatic diseases is to be expected in the BJD, the new chapter on population studies of musculoskeletal morbidity is most welcome in documenting the burden of such diseases in other than medical taxonomy.

    The chapter on rheumatoid arthritis has been largely rewritten to reflect the in-depth approach of genetics, new methods, and recent results while that on juvenile rheumatoid arthritis takes into account advances in classification as well as in genetics.

    Spondyloarthropathies and related seronegative or B27 related diseases are covered in three chapters on psoriasis, ankylosing spondyloarthropathies (inflammatory bowel disease and acute anterior uveitis), and reactive arthritis and Reiter’s syndrome. Although this forms a single topic, the presentation used by the authors is thoughtful. Further evolution in classification may be necessary. Chapters on other rare diseases like lupus, scleroderma, polymyalgia rheumatica, myositis, and systemic vasculitis provide in-depth information about recent advances in familial clustering, twin studies, genetic models, immunogenetics, etc.

    The osteoarthritis chapter includes a prognosis section, which provides an understanding of outcomes. A tabular summary of occurrence data on osteoarthritis would have been welcome. This chapter is an important contribution to information about one of the most common conditions.

    A clear synthesis of complicated data is given in the chapter on osteoporosis. New insights from contributors with innovative views are given on back pain, arm disorders, and fibromyalgia.

    Epidemiology of the rheumatic diseases reflects the evolution of taxonomy, conceptualisation, knowledge, and increasingly documented epidemiology in the broad area of the rheumatic diseases and is abundantly documented. It is useful for both clinicians and epidemiologists. Authors and editors are to be commended for producing this second edition and should be encouraged to keep pace with changes in the field by preparing a third edition when opportune. Why not as a measure of progress by the end of the BJD?

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