Pathophysiology-Rheumatoid Arthritis

triggered by external and internal factors

Immune Deficiency of T-lymphocyte system Swelling in joints, associated

pains, siffness, and fatigue

Uncontrolled synthesis of antibodies (IgG) by B Cell

Produces RA Factors against IgG

Immune complexes formation begins

Immigration of polymorphonuclear leukocytes to the synovial fluid

Neutrophil accumulation in synovial fluid Warmth, swelling,

Cell proliferation effusions, pain
No cartilage invasion Decreased motion

Lesion of microcirculatory vessels and development of Increase physical signs

inflammatory changes in synovium and symptoms

Continuous inflammation stimulates synovial membrane

Subchondral bone erosion
Pannus invasion of cartilage
Chondrocyte proliferation Joint instability,
Laxity of ligaments contractrures
Decreased ROM, systemic
complications
Rheumatoid Arthritis
 Osteoarthritis

genetic, metabolic, and local factors

process of cartilage deterioration

cartilage damage at the level of the chondrocytes

causes the normally smooth, white, translucent articular cartilage to become dull, yellow, and granular.

cartilage gradually becomes softer, less elastic, and less able to resist wear with heavy use.

body’s attempts at cartilage repair cannot keep up

changes in the collagen structure of the cartilage lead to fissuring and erosion of the articular surface

central cartilage becomes thinner, cartilage and bony growth (osteophytes) increase at the joint margins.

incongruity in joint surfaces creates an uneven distribution of stress across the joint

contributes to a reduction in motion.

synovitis result when phagocytic cells try to rid the joint of small pieces of cartilage torn from joint surface

articular cartilage has deteriorated completely

Osteoarthritis
 Gouty Arthritis

Hyperuricemia

sudden increases or decreases of serum uric acid levels

accumulations of sodium urate crystals-tophi

deposited in peripheral areas of the body, such as the great toe, the hands, and the ear

the urate crystals precipitate within a joint

inflammatory response occurs

Gout