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Epidemiology of, risk factors for, and possible causes of rheumatoid arthritis

Sherine E Gabriel, MD
Cynthia S Crowson, MS
Section Editor
Ravinder N Maini, BA, MB BChir, FRCP, FMedSci, FRS
Deputy Editor
Paul L Romain, MD


Rheumatoid arthritis (RA) is a common disorder that may have plagued ancient people, although it has been recognized with increased frequency since the 19th century [1]. In the mid-19th century, Garrod was the first to distinguish RA from gout and rheumatic fever. In one study of the period from 1955 to 2007, following four decades (1955 to 1994) of decline, the incidence of RA during the subsequent interval (1995 to 2007) appeared to increase [2].

The cause of RA is not known, but many possible etiologies have been identified. Important etiologic clues have been suggested by the identification of unique features of populations with a predilection for RA. As an example, the observation of geographic clustering of the disorder in ancient skeletons implies an important role for environmental factors, which are still poorly defined [1]. In addition to environmental factors, hormonal, genetic, infectious, and other variables also contribute to RA in some manner.

Multiple different factors probably interact in genetically susceptible hosts to initiate polyarticular synovitis. Once started, the process ultimately becomes self-perpetuating. (See "Pathogenesis of rheumatoid arthritis".)

The epidemiology, risk factors for, and possible causes of rheumatoid arthritis will be reviewed here. The pathogenesis of the synovitis in this disorder, including the roles of T cells, B cells, and cytokines, is discussed separately. (See "Pathogenesis of rheumatoid arthritis".)


The annual incidence of rheumatoid arthritis (RA) has been reported to be around 40 per 100,000. The disease prevalence is about 1 percent in Caucasians but varies between 0.1 percent (in rural Africans) and 5 percent (in Pima, Blackfeet, and Chippewa Indians) [3,4]. Women are affected two to three times more often than men.

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Literature review current through: Oct 2017. | This topic last updated: Sep 16, 2016.
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