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As such, it can be thought of as a tumor-like tissue, although mitotic figures are rare and, of course, metastasis does not occur. au bon pain, arthritis support groups, canadian arthritis society, rheumatoid arthritis ra, thumb arthritis, exercises for rhuematoid arthritis, underarm pain diagnosis, arthritis of the back, juvenile rheumatoid arthritis foundation, spinal disorders arthritis Arthritis support groups. (top of section) Cartilage Composed primarily of type II collagen and proteoglycans, this is normally a very resilient tissue that absorbs considerable impact and stress. In RA, its integrity, resilience and water content are all impaired. This appears to be due to elaboration of proteolytic enzymes (collagenase, stromelysin) both by synovial lining cells and by chondrocytes themselves. au bon pain, arthritis support groups, canadian arthritis society, rheumatoid arthritis ra, thumb arthritis, exercises for rhuematoid arthritis, underarm pain diagnosis, arthritis of the back, juvenile rheumatoid arthritis foundation, spinal disorders arthritis Remedy for toothache pain. Polymorphonuclear leukocytes in the synovial fluid may also contribute to this degradative process. (top of section) Bone Composed primarily of type I collagen, invading synovium causes erosion of contiguous bone via release of prostaglandins and proteases by synovial cells and, possibly, by osteoclasts. (top of section) Synovial Cavity Synovial Cavity Normally only a "potential" space with 1-2ml of highly viscous (due to hyaluronic acid) fluid with few cells. au bon pain, arthritis support groups, canadian arthritis society, rheumatoid arthritis ra, thumb arthritis, exercises for rhuematoid arthritis, underarm pain diagnosis, arthritis of the back, juvenile rheumatoid arthritis foundation, spinal disorders arthritis Thumb arthritis. In RA, large collections of fluid ("effusions") occur which are, in effect, filtrates of plasma (and, therefore, exudative - i. e. , high protein content). The synovial fluid is highly inflammatory. However, unlike the rheumatoid synovial tissue that is infiltrated with lymphocytes and macrophages but not neutrophils, the predominant cell in the synovial fluid is the neutrophil. (top of section)(top of page) Radiology The radiographic features of this disease correlate well with the histopathologic changes described above. Normal synovium lines, and is anchored to, both sides of the joint. The hypertrophied rheumatoid synovium begins its invasion of bone at these sites of attachment and this is seen radiographically as erosions on either or both sides of the joint. (slide). In addition to bone erosion, the height of cartilage is progressively and symmetrically reduced, consistent with a degradative process from within cartilage (chondrocyte mediated) or from exposure to synovial fluid (neutrophil mediated). (top of page) Initiation of Disease DR4 Susceptibility The Shared Epitope MHC-T cell-Peptide Interaction DR4 Susceptibility A number of autoimmune diseases have been linked to one or more alleles of the major histocompatibility complex (MHC).
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