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As an introduction, a hypothesis for the causation of ankylosing spondylitis, reactive arthritis, psoriatic arthritis, and rheumatoid arthritis is outlined. It comprises ten basic mechanisms. With that hypothesis as a background, a further ten issues based on clinical evidence are presented for discussion. Finally, four questions are presented on behalf of the clinicians.
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D. A. Brewerton (1990) studied this question.
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