Rheumatoid arthritis (RA)

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks synovial joints. The process produces an inflammatory response of the synovium (synovitis) secondary to hyperplasia of synovial cells, excess synovial fluid, and the development of pannus in the synovium. The pathology of the disease process often leads to the destruction of articular cartilage and ankylosis of the joints. Rheumatoid arthritis can also produce diffuse inflammation in the lungs, pericardium, pleura, and sclera, and also nodular lesions, most common in subcutaneous tissue under the skin. Although the cause of rheumatoid arthritis is unknown, autoimmunity plays a pivotal role in its chronicity and progression.

Ankylosed Joints

Ankylosis, or Anchylosis (from Greek ἀγκύλος, bent, crooked) is a stiffness of a joint, the result of injury or disease. The rigidity may be complete or partial and may be due to inflammation of the tendinous or muscular structures outside the joint or of the tissues of the joint itself. Noma – a gangrenous disease still widespread among malnourished children living on the borders of the Sahara desert – can cause ankylosis of the maxilla and mandible, impairing the ability to speak and eat.

When the structures outside the joint are affected, the term “false” ankylosis has been used in contradistinction to “true” ankylosis, in which the disease is within the joint. When inflammation has caused the joint-ends of the bones to be fused together the ankylosis is termed osseous or complete. Excision of a completely ankylosed shoulder or elbow may restore free mobility and usefulness to the limb. “Ankylosis” is also used as an anatomical term, bones being said to ankylose (or anchylose) when, from being originally distinct, they coalesce, or become so joined together that no motion can take place between them.