ee _. showed enlargement of the proximal! and distal Table 18 interphalangeal joints and ulnar deviation of the hand. No rhuematoid nodules were present. The x-ray changes were consistent with a diagnosis of Results of Bentonite Flocculation Test Age, yr No. in age group BFT tuter O ; Q- 9 10-19 20-29 30-39 40-49 50-59 >60 Total Me te nye bse osteoarthritis of the hands, but there was no eviee las but rheumatoid arthritis cannot be completely ruled out. Males L+ 24 7 9 13 Ll tt 9 3 2 2bo003 Ue 15 ot lL Q = = = 20 9 1 = 9 2 = ~ - ~ { | - 99 84 0 0 2 9 + 4. Unusual Skeletal Findings As noted previously, hand and wrist x-ravs had. shown congenital hypoplasia of the middle phalanx in some children. The same condition was noted in some of the adults (Figure 12). The mid- dle phalanx of the fifth finger was shortened and sightly broadened. This was found both unilater- 2 1 l _ - = 1 | 2 2? 1 6B = = I = { 2 _ - ~ - ~ 1 ~ - o 85 66 wn 8 13 {io 18 14 12, 5 5 8 7 16 11 ~ Total 12 ao 0- 9 o Females 10-19 20-29 30-39 40-49 50-39 >>60 dence for rneumatoid arthritis. The BFT was negative. This is probablya case of osteoarthritis, ally and bilaterally and was occasionally associated with lengthening of the ulna. Twenty subjects showed definite changes, and some additional ones had only moderate shortening of the phalanx. * DENTAL SURVEY P Majuro Children 2. Rheumatoid Factor in Sera The prevalence of sera positive for “rheumatoid factor” by the bentonite flocculation test (BFT) is shown in Table 18. Individual data arelisted in Appendix 6 according to age and sex. The total prevalence of positive sera is not greatly different from that reported for white American populations. There was no apparent difference in arthritis incidence between the exposed and unexposed groups. Three individuals, all in the unexposed group, had definitely positive sera (Table 19), but Thirty Majuro children were examined, ranging in age from 2 to 13 years andselected at random. Widespread caries were present in 75% of the children <12 years old. Many erupting per- manent teeth showed retained root fragments in the adjacent gingival crevice. Although the oral hygiene could be rated fair to good, the incidence of caries remained high. Bunching of the lower incisors was a common finding in males and females in the 7 to 9-year age group. Eruption time these findings, since they were common in the of the bicuspids appeared advanced, possibly because of premature loss of the deciduous "Jars. All the children in this age group showed signs of retarded jaw development in comparison with children in the continental United States. no apparent explanation for the presence of rheu- Rongelap Children with no evidence of joint disease. One (#953) had bronchial asthma and prostatic hypertrophy, but population, were probably coincidental. Thereis matoid factor in these individuals. a 'y 3. Clinical Evidence of Arthritis A 59-year-old male (#878) had some clinical findings compatible with rheumatoid arthritis. He had complained of pain and swelling in his hands, wrists, and knees for 5 to 10 years, but with no limitation of function. Physical examination No significant difference was found in caries incidence, eruption time, and morphology of the teeth, or growth of the jaws, between the exposed and the unexposed children. In both groups about 20%showed retarded jaw development which had resulted in narrowing of the arches plus bunching ofthe lower anterior teeth. The Rongelap children had a much lower incidence of caries than