Professional Documents
Culture Documents
- joint effusion
- erosion (up to 47% within 1st year after onset) initially at bare area (= site of
attachment of internal synovial layer of joint capsule to bone) due to lack of
protective cartilage layer
LATE SIGNS:
- mallet finger = droopy distal phalanx due to disrupted extensor tendon insertion
site
- dislocation
- rice bodies = subset of loose bodies resembling polished rice (made of sloughed
fibrinogen-coated infarcted synovial tissue / precipitate of fibrin + fibronectin /
core of mononuclear cells, blood cells and amorphous material)
-bony ankylosis
- marginal + central bone erosions (less common in large joints); site of first
erosion is classically base of proximal phalanx of 4th finger
@ Cervical spine
- erosions of odontoid process (1) between anterior arch of atlas + dens, (2)
between transverse ligament of atlas + dens, (3) at tip of odontoid process
- cranial settling= odontoid process projects into skull base due to significant
disease of atlanto-occipital and atlantoaxial joints
- osteoporosis
@ Ribs
@ Shoulder
- osteoporosis
- rare ankylosis
@ Knee
- osteoporosis
- superficial + deep marginal + central erosions
@ Foot (typical)
o Target areas:
medial aspect of MT heads (2,3,4), medial + lateral aspect of
MT5 (earliest sign); interphalangeal joints of foot (esp. great
toe); midfoot joints; talonavicular, subtalar, tarsometatarsal
joints; bilateral + symmetric
- retrocalcaneal bursitis
- Pulmonary manifestations
- pleural effusion, mostly unilateral, without change for months, usually not
associated with parenchymal disease
- Subcutaneous nodules
- Cardiovascular involvement
Pericarditis (20–50%)
Myocarditis (arrhythmia, heart block)
Aortitis (5%) of ascending aorta آ± aortic valve insufficiency
- Rheumatoid vasculitis
- Neurologic sequelae
- juxtaarticular osteoporosis
- Hand / foot
- Axial skeleton