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“Thingsmaycometothosewhowait,butonlythethingsleftbythosewhohustle.”
–AbrahamLincoln
PathologyofArthritisDr.VenkateshM.Shashidhar.AssociateProfessorofPathologyFijiSchoolofMedicine
Joints:Mobility-Cranialsutures?Shoulderjoint.Articularcartilage–hyaline–frictionres.Synovialfluid–lubric/nutri,TypeABsynoviocytes.HyaluronidaseContinuousproductionandabsorption.AffectedbyInflammation,immobility.Capsule,ligaments,menisci.Vascular,richnervesupply–Art.Cartilage*
Joints-Anatomy
Arthritis-IntroductionInflammationofjoints-CommonCommonsiteforautoimmuneinjuryHeartvalvesJoints-damage–Exposureofhiddenantigens.Infections.Degeneration–Age/Stress/lifestyleUseitorLooseit….!
Arthritis–Clinicalfeatures:Pain?Inflammation-capsule,synovium,periosteum.Swelling:?inflammation,effusion,proliferation.Restrictedmovement?pain,fluid,synovialswelling,damage.Deformity?mal-alignment,erosion,ankylosis
ArthritisClinicalClassification:Monoarthritis:Local,asymmetric,secondary.Acute:Bacterial,Trauma,Crystal,ReactiveChronic:Tuberculosis,Lyme,Fungal,Trauma,Tumors.Polyarthritis:Chronic,symmetric,systemic.Autoimmune,degenerative,Crystal.Rarelyinfective.
PolyarthritisClassification:Autoimmune:Rheumatic,Rheumatoid,Ankylosingspondylitis,Reitersyndromeetc.Degenerative:OsteroarthritisCrystalDeposition:Gout–MonosodiumurateCPPD-PseudoGoutInfective-Septic,TB,Lymeetc.rare.
Rheumatoid
Arthritis
EpidemiologyofRAPrevalenceabout1%ofUSpopulationFemale:Maleratio=2:1StrongassociationwithHLADR4.Concordanceinidenticaltwinsonly30%
RA-Definition:ChronicMultisystemautoimmuneinflammatorydisorderprimarilyaffectingjointsproducingaproliferativesynovitisthatoftenprogressestodestructionofthearticularcartilageandankylosis.
Etiology:GeneticSusceptibility:HLADR4,orDR1in65%to80%cases.Microbialincitingagent:Epstein-Barrvir
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