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In their correspondence about pain in the rheumatic diseases, Thompson and Carr report that some of their cohort of 100 patients with inflammatory arthritis show a disassociation between reported pain and objective measures of disease activity.1In most patients there was a close linear relation between change of reported pain, the number of swollen joints, and C reactive protein over two years. However 18 patients reported high pain scores despite no evidence of C reactive protein or swollen joint activity. On the other hand 10 patients reported no pain despite active disease. The difference could not be explained on the grounds of joint deformity. Thompson and Carr do not set out to explain their finding.
However their previous writings on subjects such as …
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