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George E. Ehrlich, MD
Arch Intern Med. 1978;138(5):688-689. doi:10.1001/archinte.1978.03630290008005.
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Sir William Heberden was able to marvel about the nodes that now bear his name as "being hardly ever attended with pain, or disposed to become sores, [they] are rather unsightly than inconvenient."1 The notion that these symmetrical joint changes were noninflammatory and should perhaps not be thought of as arthritis was furthered by Stecher's2 classic description in 1948. Indeed, the term osteoarthritis was thought so inappropriate, because its suffix implied inflammation, that for a time the British substituted the term "osteoarthrosis" for it and American usage preferred "degenerative joint disease." It became popular to regard these joint changes as a consequence of aging, trauma, obesity, and use, ie, a "wear and tear" arthritis. Some instances in which clearly more than a single elderly abused joint or the range of terminal interphalangeal joints were involved were recognized under the name primary generalized osteoarthritis3; symmetricality and, at least


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