Clinical, radiological and pathomorphological changes in the tissues of the shoulder and elbow joints in patients with rheumatoid arthritis

Abstract

Clinical and morphological picture of rheumatoid arthritis (RA) is characterized by a complex combination of inflammatory, distrophic, destructive, reparative, and sclerosing processes in the tissues of the joints. However structural changes in the tissues of the upper limb joints (shoulder and elbow) in cases of RA understudied. Objective: to set clinical, radiological and pathomorphological features of the tissue in the shoulder and elbow joints in patients with RA. Methods: we investigated the tissues of the shoulder or elbow joints in six patients with RA who underwent total joints replacement with the removal of fragments of the articular ends of bones and the joint capsule using clinical, radiologic and pathomorphologic analysis. Sections were stained with hematoxylin and eosin. It was found that complex pathological changes in the tissues of the articular ends and of the joint capsule are based on the functional insufficiency of the shoulder and elbow joints. Although chronic inflammatory process with an immune component of varying intensity, more often of mild or moderate intensity, is the leading factor of damage to normal structures of the joints in late terms of the disease dystrophic and destructive changes in the articular ends of bones acquire the greatest value. More pronounced dystrophic, destructive and chronic inflammatory changes noted in the shoulder joint have corresponded to morphological picture of osteoarthritis of moderate or severe grade reflecting as individual metabolic processes, topography and activity of rheumatoid inflammation as biomechanical features of the joints.