Rte showed enlargement of the proximal and distal interphalangeal joints and ulnar deviation of the Table 18 hand. No rhuematoid nodules were present. The Results of Bentonite Flocculation Test x-cav changes were consistent with a diagnosis of osteoarthritis of the hands, but there was no evi- BFT titer 0- 9 10-19 20-29 30-39 40-49 30-39 >60 Total te bts 'h2 “64 e565 but rheumatord arthritis cannot be completely Males 1+ 24 17 9 13 tt 1 9 21 fe) Q 12 9 9 3 30 1 -~ — 99 84 2 3 = I -~ 1 - = = | ~ ~ ~ | | - 9 44+ 0 0 2 l l = = - - ruled out. 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 middie phalanx of the fifth finger was shortened and shghtly broadened. This was found both unilater- Females 0- 9 10-19 20-29 30-39 40-49 12 13 18 12 6 8 10 I4 11 5 2? 1] I 23 3 - t ~ oe - 50-39 8 7 1 = ~ - _ > 60 16 Ll 2 l 2 - - - 85 66 6 7 3 G 0 1 Total dence for rheumatoid arthritis. The BFT was negative. This is probablya case ofosteoarthritis. 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 phaianx. + DENTAL SURVEY ’ Majuro Children 2. Rheumatoid Factor in Sera The prevalence of sera positive for ‘rheumatoid factor” bythe bentonite flocculation test (BFT)is shown in Table [8. Individual data are listed in Appendix 6 according to age and sex. The total prevalence of positive sera is not greatly different from that reported for white American populatrons. 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 with no evidence ofjoint disease. One ( +953) had bronchial asthma andprostatic hypertrophy, but these findings, since they were common in the population, were probably coincidental. Thereis no apparent explanation for the presence of rheu- matord factor in these individuals. ~ “ a 3. Clinical Evidence of Arthritis A 39-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 [1855 1b |UOe : 's oy ae O oe Age, yr” age group me No. in Thirty Majuro children were examined, ranging in age from 2 to 13 years and selected at random. Widespread caries were present in 73% of the children <12 vears old. Many erupting permanent teeth showed retained root fragments in the adjacent gingival crevice. Althoughthe oral hygiene could be rated fair to good, the incidence of caries rematned high. Bunching of the lower incisors was a common finding in males and females in the 7 to 9-year age group. Eruption time of the bicuspids appeared advanced, possibly because of premature loss of the deciduous molars. All the children in this age group showedsigns of retarded jaw development in comparison with children in the continental United States. Rongelap Children No significant difference was found in caries incidence, eruption time, and morphologyofthe 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 of the lower anterior teeth. The Rongelap children had a much lower incidence of caries than % _

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