Intended for healthcare professionals

Letters Rheumatoid arthritis debate

Treatment of rheumatoid arthritis is good medicine

BMJ 2011; 343 doi: (Published 01 November 2011) Cite this as: BMJ 2011;343:d6962
  1. David L Scott, president1,
  2. John Hunter, honorary president2,
  3. Chris Deighton, president elect1,
  4. David G I Scott, past president1,
  5. David Isenberg, past president1
  1. 1British Society for Rheumatology, Bride House, London EC4Y 8EE, UK
  2. 2Scottish Society for Rheumatology, Edinburgh EH2 1JQ, UK
  1. d.scott1{at}

In “Bad medicine: rheumatoid arthritis” Spence combines unsupported assertions with misleading interpretations of publications about the disease.1

We agree that the severity of rheumatoid arthritis is declining. Strong evidence shows that this reflects better medical management, including early intensive treatment, and improved healthcare organisation.2 3

We disagree, however, with many other points. The diagnosis of rheumatoid arthritis is not “increasingly subjective.” The objective finding of joint swelling on examination is the key component of all classification criteria; ultrasound …

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