Erosive Changes In Rheumatoid Arthritis

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What to expect in this article:

• Overview (Free)

• Time Frames

• Distribution

• Deformities

• Prognostic Factors

• Audio & Video Versions

Overview

The erosive changes in RA primarily occur due to inflammation and immune system dysfunction. In RA, the immune system mistakenly reacts to the synovium, the membrane lining the joints, triggering inflammation. This persistent inflammation leads to the release of enzymes, activation of white cells, infiltration of platelets and other mediators, which affect the cartilage and bone within the joint.

One of the earliest joint changes seen in RA is the formation of synovial pannus. Pannus is an abnormal tissue growth consisting of proliferating synovial cells, inflammatory cells, and blood vessels. As the pannus expands, it invades and destroys surrounding cartilage and bone. This process contributes to joint deformities, such as joint subluxation and ankylosis, characteristic of advanced RA.

Cartilage erosion is another significant erosive change in RA. The continuous inflammation disrupts the balance between cartilage formation and degradation, leading to cartilage loss. Essentially concommittent Osteoarthritis occuring at an earlier age and possibly more severely.

Bone erosion is a prominent feature of RA. Osteoclasts, cells responsible for bone resorption, are activated by inflammatory cytokines, leading to the breakdown of bone tissue adjacent to the inflamed synovium. This results in characteristic bone erosions, which can be visualized on imaging studies such as X-rays or MRI. Bone erosions contribute to joint instability, deformity, and functional impairment in RA patients.