The pathogenesis of rheumatoid arthritis in radiological studies. Part I: Formation of inflammatory infiltrates within the synovial membrane
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 i...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Sciendo
2012-06-01
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| Series: | Journal of Ultrasonography |
| Subjects: | |
| Online Access: | http://jultrason.pl/index.php/issues/volume-12-no-49/the-pathogenesis-of-rheumatoid-arthritis-in-radiological-studies-part-i-formation-of-inflammatory-infiltrates-within-the-synovial-membrane?aid=14 |
| Summary: | 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. |
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| ISSN: | 2084-8404 2451-070X |