‘In this world nothing can be said to be certain, except death and taxes.’ To these two could be added rheumatic disease. Only one in 19 of us will escape one or more significant episode of rheumatic disease. Osteoarthritis is the single commonest cause of disability and handicap in Britain. Although arthritis is seen in childhood and early adult life, the burden of joint disease increases with age. The majority of arthritic conditions have a low incidence but a high prevalence. In other words, once you get arthritis, it stays with you. Nodal osteoarthritis is seen in about 70% of women by the end of their lives in Britain, and in 55 to 60% of men. Any inflammatory disorder that damages joints will lead to secondary osteoarthritis (OA). Injury, such as that seen with the menisci of the knees, will also be complicated in later life by secondary OA. Ankylosing spondylitis never burns itself out. This is all very gloomy and perhaps we should all be ordering our bath chairs now.