Abstract
Rheumatoid arthritis is a systemic disease of connective tissue affecting many organs and structures in addition to the bones and joints. Its outstanding clinical manifestation is a chronic deforming arthritis, particularly of the hands and wrists. The chief lesion is a proliferative synovitis, of both joints and tendon sheaths, with synovial inflammation and hyperplasia often developing into large nodular masses. Although much has been written about the general radiographic features of this disease (1–4), apparently little is known concerning the pathogenesis of the bone erosions. Vague references to “malignant synovitis” and “invasion by synovium” contribute little toward recognizing the factors involved in this process. The bone lesions in rheumatoid arthritis do not develop in a haphazard manner. Their pattern is in fact characteristic and predictable (5). In this study x-ray films of the hands and wrists of patients with rheumatoid arthritis were analyzed to define this pattern more precisely in term...
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