RHEUMATOID ARTHRITIS-PATHOLOGY

SUMMARY

1. Initially starts with injury to synovial microvasculature.
2. Synovial proliferation occurs.
3. Leads to congestion, edema, and fibrin exudation.

4. T-lymphocytes infiltrate.
5. The synovium then hypertrophies (cartilage is destroyed).

6. Pannus formation occurs: the most important destructive element in RA. This is a membrane of granulation tissue that covers the articular cartilage at joint margins.
7. The pannus stimulates the release of cytokines, leading to cartilage destruction, bone erosion, and an inflammatory synovial fluid.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].