Rheumatoid arthritis: Difference between revisions

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*[http://library.med.utah.edu/WebPath/jpeg3/BONE044.jpg RA (med.utah.edu)].<ref>URL: [http://library.med.utah.edu/WebPath/EXAM/IMGQUIZ/msfrm.html http://library.med.utah.edu/WebPath/EXAM/IMGQUIZ/msfrm.html]. Accessed on: 5 December 2010.</ref>
*[http://library.med.utah.edu/WebPath/jpeg3/BONE044.jpg RA (med.utah.edu)].<ref>URL: [http://library.med.utah.edu/WebPath/EXAM/IMGQUIZ/msfrm.html http://library.med.utah.edu/WebPath/EXAM/IMGQUIZ/msfrm.html]. Accessed on: 5 December 2010.</ref>
*[http://www.nature.com/nature/journal/v423/n6937/fig_tab/nature01661_F1.html Rheumatoid arthritis (nature.com)].
*[http://www.nature.com/nature/journal/v423/n6937/fig_tab/nature01661_F1.html Rheumatoid arthritis (nature.com)].
*[http://www.medpath.info/MainContent/Skeletal/3100.GIF Synovial hyperplasia and inflammation (medpath.info)].<ref name=medpath/>
*[http://www.medpath.info/MainContent/Skeletal/3100.GIF Synovial inflammation (medpath.info)].<ref name=medpath/>
*[http://www.medpath.info/MainContent/Skeletal/3109.GIF Hyperplastic synovitis (medpath.info)].<ref name=medpath/>
*[http://ard.bmj.com/content/58/3.cover-expansion RA cartilage loss (bmj.com)].
*[http://ard.bmj.com/content/58/3.cover-expansion RA cartilage loss (bmj.com)].


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====Hand====
====Hand====
<pre>
Right Hand - Metacarpal Heads of Index Finger, Middle Finger and Ring Finger, Excision:
- Benign bone and cartilage focally associated with fibrous tissue and erosions.
- Fatty marrow space.
- NEGATIVE for significant inflammation.
- NEGATIVE for malignancy.
Comment:
The history of rheumatoid arthritis and deformities is noted.
</pre>
<pre>
<pre>
SYNOVIUM, LEFT HAND, EXCISION:
SYNOVIUM, LEFT HAND, EXCISION:
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</pre>
</pre>


==Rheumatoid nodule==
<pre>
*Abbreviated ''RN''.
KNEE - BONE AND SOFT TISSUE, LEFT, KNEE ARTHROPLASTY:
===General===
- DEGENERATIVE JOINT DISEASE WITH CHRONIC SYNOVITIS AND SYNOVIAL HYPERPLASIA.
*Seen in [[rheumatoid arthritis]] - usually only in seropositive cases, i.e. ''rheumatoid factor'' (RF) positive.<ref name=Ref_DCHH299>{{Ref DCHH|299}}</ref>
- BONE WITHOUT APPARENT PATHOLOGY.
**Exceptions are reported.<ref name=pmid6364806>{{Cite journal  | last1 = Kaye | first1 = BR. | last2 = Kaye | first2 = RL. | last3 = Bobrove | first3 = A. | title = Rheumatoid nodules. Review of the spectrum of associated conditions and proposal of a new classification, with a report of four seronegative cases. | journal = Am J Med | volume = 76 | issue = 2 | pages = 279-92 | month = Feb | year = 1984 | doi =  | PMID = 6364806 }}</ref>


===Gross===
COMMENT:
*Usually on the extensor aspect of the extremities, e.g. dorsal aspect of elbow.<ref name=Ref_Derm53>{{Ref Derm|53}}</ref>
The findings are compatible with rheumatoid arthritis.
*Typically close to a joint.{{fact}}
 
===Microscopic===
Features:<ref name=Ref_DCHH299>{{Ref DCHH|299}}</ref><ref name=Ref_Derm52>{{Ref Derm|52}}</ref>
*Necrotic collagen bundles with fibrin surrounded by:
**Palisading [[granuloma]].
*+/-Eosinophils.
 
Notes:
*Histomorphologically very similar to ''[[Granuloma annulare]]''.
 
DDx:
*[[Granuloma annulare]] - has mucin in the core of the granuloma.<ref name=Ref_Derm52>{{Ref Derm|52}}</ref>
*[[Necrobiosis lipoidica]].
 
Images:
*www:
**[http://granuloma.homestead.com/rheumatoid_nod_S89-2617-1.jpg Rheumatoid nodule (granuloma.homestead.com)].<ref name=ghc>URL: [http://granuloma.homestead.com/palisading.html http://granuloma.homestead.com/palisading.html]. Accessed on: 1 November 2010.</ref>
**[http://granuloma.homestead.com/rheumatoid_nod_S89-2617-5.jpg Rheumatoid nodule (granuloma.homestead.com)].<ref name=ghc>URL: [http://granuloma.homestead.com/palisading.html http://granuloma.homestead.com/palisading.html]. Accessed on: 1 November 2010.</ref>
**[http://library.med.utah.edu/WebPath/jpeg3/BONE045.jpg Rheumatoid nodule (utah.edu)].<ref>URL: [http://www.pathguy.com/lectures/joints.htm http://www.pathguy.com/lectures/joints.htm]. Accessed on: 1 November 2010.</ref>
*[[WC]]:
**[http://commons.wikimedia.org/wiki/File:Rheumatoid_nodule_-_low_mag.jpg Rheumatoid nodule - low mag. (WC)].
**[http://commons.wikimedia.org/wiki/File:Rheumatoid_nodule_-_intermed_mag_2.jpg Rheumatoid nodule - intermed. mag. (WC)].
**[http://commons.wikimedia.org/wiki/File:Rheumatoid_nodule_-_high_mag.jpg Rheumatoid nodule - high mag. (WC)].
 
===Sign out===
<pre>
Lesion (subcutaneous), right index finger, excision:
- Palisading granuloma with necrobiotic core, consistent with rheumatoid nodule.
</pre>
</pre>


====Micro====
==Rheumatoid nodule==
The sections show foci with strands of necrobiotic collagen surrounded by palisading granulomas. Rare Neutrophils are seen in the core of the granulomas. Multinucleated cells are not apparent.
{{Main|Rheumatoid nodule}}
 
{{Main|Rheumatoid lung nodule}}
Benign fibroadipose tissue and dense connective tissue are also present.


=Pleural disease=
=Pleural disease=
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=See also=
=See also=
*[[Arthritis]].
*[[Arthritis]].
**[[Osteoarthritis]].
*[[Basics]].
*[[Joints]].
*[[Joints]].
*[[Basics]].


=References=
=References=
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=External links=
=External links=
*[http://www.pathguy.com/lectures/joints.htm Joint disease (pathguy.com)].
*[http://www.pathguy.com/lectures/joints.htm Joint disease (pathguy.com)].
[[Category:Weird stuff]]
[[Category:Weird stuff]]
[[Category:Diagnosis]]
Retrieved from "https://librepathology.org/wiki/Rheumatoid_arthritis"