26
showed enlargement of the proximal and distal
interphalangealjoints and ulnar deviation ofthe
hand. No rhuematoid nodules were present. The
Table 18
Results of Bentonite Flocculation Test
No. in
agegroup
0
’%
‘%
‘Me
‘hr
+
‘56
Males
0- 9
10-19
20-29
30-39
40-49
50-59
> 60
14
24
17
9
13
11
11
9
21
15
9
2
9
9
3
3
1
2
2
1
=
1
-
=
=
=
=
-
=
=
1
l
=
99
84
9
4
QO
0
2
0- 9
10-19
20-29
30-39
40-49
50-59
12
13
18
12
6
8
8
10
14
11
5
7
2?
1
-~
2
3
1
]
-
t
l
=
I
=
~
~
~
_
|
~
_
_
>60
16
11
2
1
2
-
-
~
85
66
6
7
5
0
0
1
Total
As noted previously, hand and wrist x-rays had
shown congenital hypoplasia of the middle phalanx in some children. The same condition was
noted in someof the adults (Figure 12). The middle phalanx ofthe fifth finger was shortened and
slightly broadened. This was found both unilaterally 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
Majuro Children
The prevalence of sera positive for “rheumatoid
factor” by the bentonite flocculation test (BFT)is
shown in Table 18. Individual data are listed in
Appendix 6 according to age and sex. Thetotal
prevalence of positive sera is not greatly different
from that reported for white American popula-
tions. There was no apparentdifferencein arthritis
incidence between the exposed and unexposed
groups. Three individuals, all in the unexposed
group, had definitely positive sera (Table 19), but
with no evidenceofjoint disease. One (#953) had
bronchial asthma and prostatic hypertrophy, but
these findings, since they were common in the
population, were probably coincidental. Thereis
Thirty Majuro children were examined, rang-
ing in age from 2 to 13 years and selected at random. Widespread caries were present in 75% of
the children <12 years old. Many erupting per-
manentteeth showedretained root fragments in
the adjacent gingival crevice. Althoughthe 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 fe-
males in the 7 to 9-year age group. Eruption time
of the bicuspids appeared advanced, possibly because of prematureloss of the deciduous molars.
All the children in this age group showedsignsof
retarded jaw development in comparison with
children in the continental United States.
no apparent explanation for the presence of rheu-
Rongelap Children
3. Clinical Evidence of Arthritis
No significant difference was foundin 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
matoid factor in these individuals.
A 59-year-old male (#878) had someclinical
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
~<a
2. Rheumatoid Factor in Sera
resulted in narrowingof the arches plus bunching
of the lower anterior teeth. The Rongelap children had a much lower incidenceof caries than
wary
a
negative. This is probably a case of osteoarthritis,
but rheumatoid arthritis cannot be completely
ruled out.
4. Unusual Skeletal Findings
Females
Total
dence for rheumatoid arthritis. The BFT was
Ferme
Age,yr
x-ray changes were consistent with a diagnosis of
osteoarthritis of the hands, but there was no evi-
BFT titer