Presentation
The initial disease presentation in all patients was a polyarthritis. Anti-CCP antibodies were detected in 4 out of 5 (80%) patients, 2 of whom had a positive rheumatoid factor. [ncbi.nlm.nih.gov]
On the basis of this and other already published cases, rheumatoid arthritis seems to have been present in Europe more anciently than was previously thought. [arpi.unipi.it]
Constitutional complaints such as fever, malaise, weight loss, and itching are commonly present.1 Data on its incidence and prevalence are unavailable. [ard.bmj.com]
Entire Body System
- Inflammation
[…] arthritis vs. metacarpophalangeal joint predominance in rheumatoid arthritis new bone formation key, not a feature of rheumatoid arthritis 2 affects the synovioentheseal complex, explaining enthesitis, adjacent joint capsule synovitis, and periarticular inflammation [radiopaedia.org]
Urate-mediated inflammation in nodal osteoarthritis: clinical and roentgenographic correlations. Arthritis Rheum1989;32:86–90. ↵ Resnick D, Niwayama G. Gouty arthritis. In: Resnick D ed. Diagnosis of bone and joint disorders. Vol 3. [ard.bmj.com]
- Pain
Reference article, Radiopaedia.org (Accessed on 28 Nov 2022) https://doi.org/10.53347/rID-26939 Erosive arthritis has a broad differential: erosive osteoarthritis clinically an acute inflammatory attacks (swelling, erythema, pain) in postmenopausal women [radiopaedia.org]
[…] interphalangeal MRH, multicentric reticulohistiocytosis OA, osteoarthritis PAS, periodic acid-Schiff PsA, psoriatic arthritis CASE REPORT A 70 year old non-insulin dependent diabetic white woman was referred to us for a progressive deformity, only slightly painful [ard.bmj.com]
Musculoskeletal
- Arthritis
arthritis, tophaceous gout, dialysis related hand arthropathy, and from the rarer fibroblastic rheumatism, all of which can be mimicked by MRH. [ncbi.nlm.nih.gov]
Distal interphalangeal joint involvement in rheumatoid arthritis. Arthritis Rheum1986;29:10–15. ↵ Gladman DD, Shuckett R, Russel ML, Torne JC, Schachter RK. Psoriatic arthritis (PSA). An analysis of 220 patients. [ard.bmj.com]
Arthritis Rheum. 2003 Jan. [pubmed.ncbi.nlm.nih.gov]
- Osteoporosis
[…] is not a feature in psoriatic arthritis reactive arthritis predilection for the lower limb symmetrical involvement of the proximal interphalangeal joints, metacarpophalangeal joints, and carpal bones. osteopenia and then osteoporosis, uniform joint space [radiopaedia.org]
However, the usual occurrence of Raynaud's phenomenon and sclerodactyly and the presence of juxta-articular osteoporosis in fibroblastic rheumatism, the latter being disproportionately mild with respect to the erosive changes in MRH, are valuable features [ard.bmj.com]
- Ankylosis
[…] inflammatory attacks (swelling, erythema, pain) in postmenopausal women typically the interphalangeal joints, 1st carpometacarpal joint 6, but not the metacarpophalangeal (MCP) joints and large joints classic central erosions (gull-wing appearance); possible ankylosis [radiopaedia.org]
Subchondral sclerosis, osteophytes, joint space narrowing and, moreover, a tendency to ankylosis are typically noted also in the “erosive” variant of OA, which is considered by some authors5 merely as a phase in the evolution of finger OA. [ard.bmj.com]
- Heberden Node
Our patient presented with swelling limited to DIP finger joints, resembling Heberden's nodes (fig 1A). Such a sign might have pointed to a diagnosis of nodal OA of the hands. [ard.bmj.com]
- Osteophyte
The characteristic radiological changes of interphalangeal finger OA, such as subchondral bone sclerosis, joint space narrowing, and marginal osteophytic bone outgrowths, were absent. [ard.bmj.com]
Treatment
Hence, the treatment of this disease remains largely empirical. [ard.bmj.com]
MRI thus helps to distinguish different types of lupus arthritis/Jaccoud's arthropathy, which allows more differentiated treatment strategies and monitoring. [pubmed.ncbi.nlm.nih.gov]
Etiology
The etiology and pathogenesis of the disease is poorly understood. [ncbi.nlm.nih.gov]
Then, a careful differential diagnosis was necessary to clarify the etiology of the polyarthropathy; the skeletal distribution of the lesions and their macroscopic and radiological appearance are suggestive of a case of rheumatoid arthritis-like polyarthropathy [arpi.unipi.it]
Pathophysiology
Its precise pathophysiology or etiology remains unclear. [ncbi.nlm.nih.gov]