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2012 ; 12
(49
): 202-13
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
The pathogenesis of rheumatoid arthritis in radiological studies Part I:
Formation of inflammatory infiltrates within the synovial membrane
#MMPMID26673660
Sudo?-Szopi?ska I
; Kontny E
; Ma?li?ski W
; Prochorec-Sobieszek M
; Kwiatkowska B
; Zaniewicz-Kaniewska K
; Warczy?ska A
J Ultrason
2012[Jun]; 12
(49
): 202-13
PMID26673660
show ga
Rheumatoid arthritis is a chronic inflammatory disease with a multifactorial
etiology and varied course, which in the majority of patients leads to partial
disability or to permanent handicap. Its characteristic trait is a persistent
inflammation of the synovial membrane and the formation of an invasive synovial
tissue, called the pannus, which in time leads to destruction of the cartilage,
subchondral bone tissue, and the soft tissue of the affected joint(s). The
pathogenesis of rheumatoid arthritis is complex and involves cells of both innate
and adaptive immunity, a network of various cytokines and an immunoregulatory
dysfunction. An important role in the discovery of rheumatoid arthritis
pathogenesis was played by magnetic resonance imaging, which showed the disease
process to extend beyond the synovium into the bone marrow. Many studies have
shown a strict correlation between the vascularity of the synovium (assessed
through the power Doppler ultrasound and magnetic resonance examinations), bone
marrow edema and the clinical, laboratory and histopathological parameters of
rheumatoid arthritis. From the current understanding of rheumatoid arthritis,
bone erosions could occur from two directions: from the joint cavity and from the
bone marrow. With power Doppler ultrasound, as well as in magnetic resonance
imaging, it is possible to visualize the well-vascularized pannus and its
destructive effects on joint structures and ligaments. In addition, the magnetic
resonance study shows inflammatory and destructive changes within the bone marrow
(bone marrow edema, inflammatory cysts, and erosions). Bone marrow edema occurs
in 68-75% of patients with early rheumatoid arthritis and is considered to be a
predictor of rapid disease progression.