B Knee involvementxxCBony ankylosis / xtic of Rh Arthritis
The prominent ulnar deviation of the hands and "swan neck"deformity of the fingers is due to rheumatoid arthritis (RA). This autoimmunedisease leads to synovial proliferation with inflammation and joint destruction,typically in asymmetrical pattern involving small joints of hands and feet,followed bywrists, ankles,elbows, and knees. Rheumatoid factor can be
identified serologically in most 80%, but not all, RA patients.
Sometimes persons with rheumatoid arthritis (RA) haverheumatoid nodulesform in subcutaneous locations at pressure points, such asthe elbow shown here. Rheumatoid nodules may also appear viscerally, such ason the pleura of the lung.
This is the synovium in rheumatoid arthritis. There ischronicinflammation with lymphocytes and plasma cellsthat produce the blue areas beneath the nodular proliferations. This"pannus" is destructive and produceserosion of the articular cartilage, eventually destroying the joint.
D Morning stiffness and gets worse with useE Heberden's nodes and crepitus and wt bearing jtsQuestion 6A 13-year-old boywith pain in his left leg is found to have aneoplasm of the femur ( + Pelvis)that
radiologicallyis diaphysealin location and on biopsy is seen microscopically to becomposed of numerous small round blue cells. He also has fever. The probable diagnosisis:zzA Ewing's sarcoma ( Homer Wright rosette)3