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Comparative osteological analysis of the knee, hip, shoulder, and elbow joints of 798 individuals from four human skeletal populations (Black and White Americans, Pueblo Indians, and Alaskan Eskimos) indicates that age of onset, frequency, and location of degenerative changes are directly related to the nature and degree of environmentally associated stress, as reflected by the variable life styles of the populations sampled. Eskimos have the earliest onset and most severe involvement for all four joints studied, the right side is usually more affected than the left, and Blacks are more frequently involved than Whites in the knee, shoulder, and elbow. Functional stress, when constant and severe in nature, becomes the primary focus of degenerative disease, but other background contributing agents such as age, sex, and hormonal influence must not be ignored.<\/jats:p>","DOI":"10.1002\/ajpa.1330460214","type":"journal-article","created":{"date-parts":[[2005,8,9]],"date-time":"2005-08-09T08:57:08Z","timestamp":1123577828000},"page":"353-365","source":"Crossref","is-referenced-by-count":120,"title":["Stress and the etiology of osteoarthritis"],"prefix":"10.1002","volume":"46","author":[{"given":"Robert D.","family":"Jurmain","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2005,4,29]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.21.4.342"},{"key":"e_1_2_1_3_1","volume-title":"Synovial Joints: Their Structure and Mechanics","author":"Barnett","year":"1961"},{"key":"e_1_2_1_4_1","first-page":"129","article-title":"Osteoarthritis deformans of the temporomandibular joint","volume":"17","author":"Bauer W. 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