Trauma & Inflammatory Arthritis
Inflammatory arthropathies are those conditions of the musculoskeletal system that are mediated by the immune
system, as opposed to those that are caused by trauma, use, or age. Examples of inflammatory arthropathies are
psoriatic arthritis, rheumatoid arthritis, seronegative arthritis, and ankylosing spondylitis. In addition, there are
certain localized inflammatory problems like carpal tunnel syndrome. While the etiologies (causes) are generally
accepted to be multi-factorial, affected patients frequently identify traumatic events as inciting factors. Since no
single etiology has been identified in any particular type of inflammatory arthritis, this is an area of potential
legal conflict. Most experts rely on the "conventional wisdom" that trauma does not cause inflammatory arthritis, and
extrapolate to the conclusion that trauma is therefore not identifiable as a precipitating event.
literature conclusively shows that traumatic events can not exacerbate or precipitate these diseases. While there is
no evidence to support the conclusion that trauma can be the sole etiologic agent, the literature contains hundreds of
cases in which trauma was clearly the inciting factor, leading first to localized, and then to generalized disease.
More importantly, there are several published statistical analyses to support this concept. Furthermore, there are
scientifically valid theories as to probable pathophysiology.
The illustrations below show a knee with a large,
inflammatory effusion, and a pair of hands with fairly typical, moderately advanced rheumatoid arthritis.