Prevalence of Spondylosis in Urban Bikaner Population in Western Rajasthan: A WHO-ILAR COPCORD Study

COPCORD (Community oriented program from control of rheumatic diseases) is a global initiative of the WHO/International League of Associations from Rheumatology (ILAR). The prevalence data from Urban Area, Bikaner District, North-Western Rajasthan Carried out in 2008-09, is presented. The aim was to study the urban prevalence of rheumatic-musculoskeletal symptoms/diseases (RMSD). A cross-sectional survey of the urban population of Bikaner (non-randomised selection) was completed in five weeks, using validated questionnaires, served by trained volunteers.356 patients (7.12%) were identified (Phase 1) from 5000 adults, and systematically evaluated (Phase 2 and 3) by a medical team, including a rheumatologist, limited investigations were carried out and diagnosis confirmed during a planned 12 week initial follow-up. Standard clinical criteria were used for the diagnosis, point prevalence estimates (prev) are shown in parenthesis. There was a dominant distribution of 'pain at all sites' (articular/soft tissues) in the females (5.06%), as compared to males (2.06%).51.4% RMSD were due to Osteoarthritis (females 33.99%, males 17.42%), Inflammatory arthritis (RA) as classified by the American College of Rheumatology, ranking second [35.67% (females 28.93%, males 6.74%)], Unclassified ill defined (4.21%). Spondylosis (Lumbar 2.53, Cervical 1.12%, Cervical and Lumbar 1.12%), Post Traumatic Arthritis (1.12%), Low backache spondylitis, Soft Tissue Rheumatism and Osteoarthritis with spondylosis (0.56% each), 1 person (0.28%) was suffering with prosthetic arthritis, 1 (0.28%) person was suffering with Trigeminal Neuralgia with wrist pain. TB, leprosy, gout and connective tissue disorders were not observed. The Bikaner COPCORD survey demonstrates a significant urban spectrum of RMSD. It provides a reasonable speculation about the Indian rheumatological burden with osteoarthritis and rheumatoid arthritis scoring first and second respectively.