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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.

No available 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.

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