Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0003873 (rheumatoid arthritis)
 53,068 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Osteoarthritis may be divided into primary generalized and secondary forms. Primary generalized osteoarthritis is characterized by narrowing of cartilage, marginal osteophytes, and absence of erosions. The most common sites of involvement are the distal interphalangeal joints of the fingers and the first carpometacarpal joint. Secondary osteoarthritis also results in narrowing of cartilage in the absence of erosions, but in regions of mechanical stress. Erosive osteoarthritis affects predominantly the proximal and distal interphalangeal joints, and evolves into bony fusion in 12 to 15 per cent of cases, about the same percentage of interphalangeal bony fusion that occurs in psoriatic arthritis. Ankylosing spondylitis predominates in the axial skeleton where it eventually leads to fusion of the vertebrae and sacroiliac joints. Psoriatic arthritis combines many features of rheumatoid arthritis, in which synovial inflammation predominates, and ankylosing spondylitis, in which ligamentous inflammation predominates. The hands and feet are involved to an equal extent, and in 20 per cent of patients the disorder also involves the sacroiliac joints and spine. Reiter's disease, like psoriatic arthritis, differs from ankylosing spondylitis in its inconstant involvement of the spine and greater involvement of peripheral joints. Reiter's disease differs from psoriatic arthritis in its predominant involvement of the lower limbs, particularly the feet, with relative sparing of the hands and wrists. Multicentric reticulohistiocytosis is a rare disorder in which polyarthritis usually precedes the onset of nodular cutaneous eruptions, a fact that emphasizes the importance of early roentgenologic recognition. The interphalangeal joints are the predominant sites of involvement in the hands, but eventually all of the synovium lined joints become affected, with arthritis mutilans the end result in one third of cases. The erosions are strikingly symmetrical and well circumscribed, and accompanying osteoporosis is disproportionately mild. Progressive systemic sclerosis is characterized by atrophy and dystrophic calcifications in the soft tissues, ultimately leading to joint deformities and resorption of the terminal tufts of the phalanges. Resorption of bone occurs at other sites as well, and marginal erosions may develop in the metacarpophalangeal and interphalangeal joints of the hands.
 ...
PMID:The other arthritides. Roentgenologic features of osteoarthritis, erosive osteoarthritis, ankylosing spondylitis, psoriatic arthritis, Reiter's disease, multicentric reticulohistiocytosis, and progressive systemic sclerosis. 305 Oct 93

Erosive osteoarthritis (EOA) is a peculiar form of osteoarthritis, characterized by inflammatory destructive changes (erosions) in the interphalangeal joints, with relative sparing of the metacarpophalangeal joints, and frequent involvement of the trapeziometacarpal joint. Linear periosteal bone apposition is also commonly reported. In EOA, erosions tend to occur exclusively in the subchondral cortex of joints, causing in DIP joints a typical "gull wings" configuration of bones of distal phalanges, whereas in psoriatic arthritis (PA) and in rheumatoid arthritis (RA) the "bare areas" are primarily affected. However, such "gull wings" erosions are nonspecific, and may be observed in the late stage of PA in the IP joints, or RA in the PIP joints.
 ...
PMID:[Erosive arthrosis of the hand. Criteria of the differential diagnosis]. 405 95

The articular manifestations of progressive systemic sclerosis (PSS) were studied in 38 patients. Of these, 66% experienced joint pain and 61% had signs of joint inflammation. Limitation of joint movement was seen in 45%. Radiological abnormalities included periarticular osteoporosis (42%), joint space narrowing (34%), and erosions (40%). Erosive disease did not correlate with disease duration, presence of rheumatoid factor, antinuclear antibodies, distal tuft resorption, or the extent of the scleroderma skin changes. Calcinosis was seen more frequently in those patients with articular erosions (67%). Erosive osteoarthritis of the distal interphalangeal joints (7 patients) was associated with impaired finger flexion. Joint involvement in PSS occurs frequently and may resemble rheumatoid arthritis in the early stages but is less destructive. The occurrence of unrelated arthropathy, such as primary osteoarthritis, is not uncommon, and its differentiation from true PSS joint disease can be difficult.
 ...
PMID:The articular manifestations of progressive systemic sclerosis (scleroderma). 707 43

Erosive osteoarthritis is a disorder that most often involves the hands of postmenopausal women. It can begin abruptly with pain, swelling, and tenderness. Distal interphalangeal joints are involved most frequently, followed by proximal interphalangeal joints. Occasionally there is metacarpophalangeal, carpal, or large joint involvement. The female-to-male ratio is approximately 12:1. There are no known HLA associations. Laboratory studies generally are negative. A mild elevation of the sedimentation rate may occur. Radiologically, the disorder is characterized by central erosions and the "gull wing" deformity. Synovial pathology has shown changes consistent with both rheumatoid arthritis and osteoarthritis and manifests the stage of disease at the time of biopsy. The etiology remains obscure, but hormonal influences, metabolic disorders, and autoimmunity have been implicated. Treatment is largely supportive with physical therapy, nonsteroidal antiinflammatory drugs, and occasionally prednisone. Overall prognosis is good, although deformity and impairment of hand function may occur. For this reason, a reassessment of treatment strategies may be in order.
 ...
PMID:Erosive osteoarthritis. 851 94

Erosive osteoarthritis (EOA) is a progressive disorder affecting the interphalangeal joints of the hands. Severe synovitis is superimposed on the typical changes seen in conventional interphalangeal osteoarthritis (OA), which includes formation of Heberden's and Bouchard's nodes. Imaging studies show a combination of bony proliferation (osteophytosis), periosteal reaction, and articular erosions, which assume "gull-wing" configuration. Differential diagnosis includes classic "degenerative" OA, rheumatoid arthritis, and psoriatic arthritis.
 ...
PMID:Erosive osteoarthritis. 1292 Jun 53

Erosive osteoarthritis (EOA) is believed to be a clinically uncommon subset of generalized osteoarthritis (OA) characterized by a clinical course, which is frequently aggressive. The diagnosis of EOA is accepted only for patients meeting American College of Rheumatology clinical criteria for OA of the hand and showing radiographic aspects of articular surface erosions. Conditions to be considered in the differential diagnosis include primarily nodal generalized OA, psoriatic arthritis and rheumatoid arthritis. It is possible to find erosive changes resembling EOA in endocrine diseases, microcrystal-induced diseases, chronic renal diseases, autoimmune diseases and others. Despite the absence of a clear etiology, immunogenetic studies are useful in identifying a possible predisposition to developing EOA in some subjects. No definitive therapeutic approach to EOA has been reported. It is reasonable to assume that in the presence of a symptomatic EOA our therapeutic approach should differ from that used for common, nodal, non-EOA.
 ...
PMID:Erosive osteoarthritis. 1545 30

Erosive osteoarthritis, a less common subtype of osteoarthritis, is often described as a more severe form. This combination of cartilage degeneration with pathologic features suggestive of inflammatory synovial changes generally manifests in women around the time of menopause and hormonal levels as well as genetics are thought to play a role in its onset. The hands are most often involved with the sudden onset of palpable pain and swelling of the distal interphalangeal joints and proximal interphalangeal joints most frequently, but other joints have been reported. Phalangeal deformities appearing as wavy or subluxed as well as Heberden and Bouchard nodes can be seen clinically. Laboratory tests for systemic inflammation are usually normal but small studies looking at markers of bone resorption have shown increased levels in these patients. Radiographs reveal central joint erosions implying an inflammatory process which has been described in synovial specimens. Treatment options that have been tried include those utilized for general osteoarthritis as well as those for rheumatoid arthritis. Since prolonged disability in hand function can occur, further studies looking at its pathogenesis and targeted treatment options are needed.
 ...
PMID:Erosive osteoarthritis: a current review of a clinical challenge. 2010 14

Erosive osteoarthritis is a term utilized to describe a specific inflammatory condition of the interphalangeal and first carpal metacarpal joints of the hands. The term has become a part of medical philosophical semantics and paradigms, but the issue is actually more complicated. Even the term osteoarthritis (non-erosive) has been controversial, with some suggesting osteoarthrosis to be more appropriate in view of the perspective that it is a non-inflammatory process undeserving of the "itis" suffix. The term "erosion" has also been a source of confusion in osteoarthritis, as it has been used to describe cartilage, not bone lesions. Inflammation in individuals with osteoarthritis actually appears to be related to complicating phenomena, such as calcium pyrophosphate and hydroxyapatite crystal deposition producing arthritis. Erosive osteoarthritis is the contentious term. It is used to describe a specific form of joint damage to specific joints. The damage has been termed erosions and the distribution of the damage is to the interphalangeal joints of the hand and first carpal metacarpal joint. Inflammation is recognized by joint redness and warmth, while X-rays reveal alteration of the articular surfaces, producing a smudged appearance. This ill-defined, joint damage has a crumbling appearance and is quite distinct from the sharply defined erosions of rheumatoid arthritis and spondyloarthropathy. The appearance is identical to those found with calcium pyrophosphate deposition disease, both in character and their unique responsiveness to hydroxychloroquine treatment. Low doses of the latter often resolve symptoms within weeks, in contrast to higher doses and the months required for response in other forms of inflammatory arthritis. Reconsidering erosive osteoarthritis as a form of calcium pyrophosphate deposition disease guides physicians to more effective therapeutic intervention.
 ...
PMID:Distinguishing erosive osteoarthritis and calcium pyrophosphate deposition disease. 2361 Jul 48