Difference between revisions of "Rheumatoid arthritis"

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Note:
Note:
*Changes are non-specific - DDx includes other rheumatic diseases ([[systemic lupus erythematosus]], [[psoriatic arthritis]]).
*Changes are non-specific - DDx includes other rheumatic diseases ([[systemic lupus erythematosus]], [[psoriatic arthritis]]).
DDx:
*Infected joint.


Images:
Images:

Revision as of 17:25, 31 October 2012

Rheumatoid arthritis, commonly abbreviated RA, is an autoimmune disorder.

Skin

Rheumatoid neutrophilic dermatitis

General

  • May manifest as rheumatoid neutrophilic dermatitis - super rare.[1]

Microscopic

Features:

Joints

Rheumatic joint disease

  • AKA joint with rheumatic disease.

General

Clinical:

  • Tumour - swelling.
  • Rubor - redness.
  • Calor - heat.
  • Dolor - pain.

Microscopic

Features:[2]

  • Chronic inflammation, esp. lymphocytes.
    • +/-Lymphoid follicles.
  • Synovial hyperplasia - with papillary or polyoid architecture.
    • Synoviocytes may show binucleation and mild atypia.
  • +/-Fibrin.
  • +/-Bone.
  • +/-Cartilage.

Note:

DDx:

  • Infected joint.

Images:

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SYNOVIUM, LEFT HAND, EXCISION:
- SYNOVIAL HYPERPLASIA.
- CHRONIC AND FOCAL ACUTE SYNOVITIS.
- GRANULATION TISSUE AND HEMOSIDERIN-LADEN MACROPHAGES.
- SEE COMMENT.

COMMENT:
The findings are consistent with rheumatoid arthritis.

Rheumatoid nodule

General

Microscopic

Features:[4][5]

  • Necrotic collagen bundles with fibrin surrounded by:
  • +/-Eosinophils.

Notes:

DDx:

Images:

Pleural disease

See Rheumatoid pleuritis.

Lung disease

See Medical lung disease.

RA may involve the lung.

Miscellaneous

Amyloidosis

See Amyloidosis.

Amyloidosis may be due to RA.

Felty syndrome

RA may occur in Felty syndrome -- the triad:[8]

Felty syndrome is associated with large granular lymphocytic leukemia.[8][9]

See also

References

  1. Mashek, HA.; Pham, CT.; Helm, TN.; Klaus, M. (Jun 1997). "Rheumatoid neutrophilic dermatitis.". Arch Dermatol 133 (6): 757-60. PMID 9197831.
  2. Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 660. ISBN 978-0781765275.
  3. URL: http://library.med.utah.edu/WebPath/EXAM/IMGQUIZ/msfrm.html. Accessed on: 5 December 2010.
  4. 4.0 4.1 Tadrous, Paul.J. Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum (1st ed.). Wiley. pp. 299. ISBN 978-0470519035.
  5. 5.0 5.1 Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 52. ISBN 978-0443066542.
  6. 6.0 6.1 URL: http://granuloma.homestead.com/palisading.html. Accessed on: 1 November 2010.
  7. URL: http://www.pathguy.com/lectures/joints.htm. Accessed on: 1 November 2010.
  8. 8.0 8.1 Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 328. ISBN 978-1416054542.
  9. Liu, X.; Loughran, TP. (Jul 2011). "The spectrum of large granular lymphocyte leukemia and Felty's syndrome.". Curr Opin Hematol 18 (4): 254-9. doi:10.1097/MOH.0b013e32834760fb. PMID 21546829.

External links