HLA B27 in Rheumatoid Factor-Negative Polyarthritis

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Abstract
Consecutive patients (83) with rheumatoid factor-negative polyarthritis seen during a 1 yr period were evaluated clinically, radiologically and with the B27 test. Patients with definite spondylitis, juvenile chronic polyarthritis, a collagen disease, a known metabolic arthropathy or primary generalized osteoarthritis were excluded. The patients could be classified into 2 groups independent of any knowledge of B27 testing. Twenty-five had a spondylitic variant syndrome. These could be diagnosed on clinical grounds and included a male preponderance and a high frequency of B27 positivity. Fifty-eight patients, who could generally be classified by American Rheumatism Association criteria as having definite or classic rheumatoid arthritis, included a female preponderance and a normal prevalence of B27. Thus the B27 test was not more helpful than clinical diagnosis in the classic spondylitic variant syndromes, nor did it separate out a population of patients from among the seronegative rheumatoid arthritis group.

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