Four principals occupied center stage in rheumatology during 1978: (1) HLA genetic markers, (2) various new as well as old drugs, (3) the genesis of osteoarthritis, and (4) perhaps the most enigmatic of them all, mixed connective tissue disease.
The HLA system of antigens continues to be implicated in the development of some of the rheumatic diseases, even if the guilt is still primarily by association. The best established relationship remains that between the HLA-B27 antigen and ankylosing spondylitis. When spondylitic changes are associated with either acute anterior uveitis or Reiter's syndrome, this strong association remains. However, the distribution of HLA-B27 among persons with nonspecific urethritis is similar to that among healthy control subjects, and, therefore, it is important that the HLA-B27 antigen be related to the joint involvement and not to the urethritis.1 The frequency of the association of the HLA antigen with the rheumatic diseases