Pathways of Destruction in Metacarpal and Metatarsal Joints of Patients with Rheumatoid Arthritis

Publisher Website
Google Scholar
Abstract
Fassbender HG, Seibel M, Hebert T. Pathways of Destruction in Metacarpal and Metatarsal Joints of Patients with Rheumatoid Arthritis. Scand J Rheumatol. 1992; 21: 10–6. 219 metatarsal (MTP) and 69 metacarpal (MCP) capitulate obtained during surgery from patients with definite rheumatoid arthritis (RA) were histological evaluated. This evaluation, focusing on primary pathways of joint destruction by tumor-like proliferated synovial cell masses revealed 3 pathways of aggression: Pathway A: In 15% aggression onto the particular cartilage only. Pathway B: In 49% direct invasion exclusively into the cortical bone. Pathway C: In 36% a “forceps-like” aggression, a combination of A and B in which the joint is attacked from both sides. In contrast to the hitherto conventional concepts, the findings of this study reveal a clear preference of the synovial aggression for the cortical bone rather than for the particular cartilage. The different concepts of joint destruction in RA are being discussed in the light of our findings. Thus, future pathogenenetic considerations with regard to joint destruction in RA should take this fact into consideration.