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- ArticleHadler NM.Arthritis Rheum. 1977 May;20(4):1019-25.Regional musculoskeletal diseases are exceedingly common in all segments of society, and dramatically so in industry. For generations, medicine has assumed that many such entities are use-associated. A critical review of several examples of back and upper extremity disease demonstrates that the literature supporting these assumptions is almost entirely anecdotal. It is argued that if defined patterns of usage were associated with defined clinical syndromes, such knowledge would have considerable therapeutic and prophylactic potential. Industrial rheumatology is proposed as an investigative discipline for the study of such relationships. The prerequisites in terms of assumptions and methods as well as potential fallacies and pitfalls are discussed.