Joint erosion is one of the most feared complications of RA.
“Joint is erosion is one of the most feared complications of rheumatoid arthritis,” says Saakshi Khattri, MD, a rheumatologist and assistant professor at the Department of Rheumatology, Icahn School of Medicine at Mount Sinai Hospital in New York City.
What Causes Joint Erosion?
Rheumatoid arthritis (RA) is an inflammatory arthritis that primarily affects the joints. Untreated RA can lead to long-term inflammation of the joints, which may eventually lead to damage and erosion of bones, cartilage, and other parts of the joints.
“All of the inflammation at the level of the joint causes formation of something called the pannus. A pannus is a very destructive granulation tissue that invades the cartilage causing cartilage destruction, and then it invades the bone causing bone erosion,” says Dr. Khattri. Joint erosion can lead to chronic pain and disability, and some patients may even need a joint replacement.
“Joint erosion is something we all aim to prevent, because what joint erosion implies is destruction of a joint. That joint won’t function as it’s intended to do,” says Dr. Khattri.
How Joint Erosion Is Prevented
Detecting joint erosion can be tricky, because it doesn’t have early symptoms that would warrant a trip to see your rheumatologist. "Joints that have erosion going on versus joints that don’t have erosion going on, as long as both are inflamed, feel no different,” says Dr. Khattri.
For that reason, it’s recommended that all patients with RA get yearly X-rays. This allows your doctor to check if there’s any disease progression or erosion in the joints. “We might even do more sensitive testing like ultrasound or even an MRI to see if there [are] erosions taking place that haven’t been picked up by an X-ray,” says Dr. Khattri.
The most important thing you can do to prevent any RA complication is to follow your treatment plan prescribed by your doctor. If inflammation is controlled, hopefully any joint destruction that is happening, or that might happen down the line, is aborted, says Dr. Khattri. Learn more about the complications of RA and how to avoid them.
“With early diagnosis and early treatment with the DMARDs that exist, we can prevent changes at the level of the bone. Not all patients with rheumatoid arthritis will develop erosions, as long as they are treated early, they’re treated adequately, there inflammation is kept in control,” says Dr. Khattri. Learn more about how rheumatoid arthritis is treated with DMARDs.
Saakshi Khattri, MD, is a rheumatologist and assistant professor at the Department of Rheumatology, Icahn School of Medicine at Mount Sinai Hospital in New York City.
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Joint erosion is one of the most feared, if I may use the word,
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complication of rheumatoid arthritis.
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What happens in joint erosion is that
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all of the inflammation at the level of the joint
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causes formation of something called the pannus.
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A pannus is a very destructive granulation tissue
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that invades the cartilage, causing cartilage destruction,
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and then it invades the bone, causing bone erosion.
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But clinically, joints that have erosion going on,
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versus the joints that don't have erosion going on,
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as long as both are inflamed, feels no different.
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So that's sort of determined by imaging modalities.
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All patients with rheumatoid arthritis get yearly X-rays,
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so that's one way of monitoring whether there's any progression
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of the disease with regards to erosion.
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We might even do more sensitive testing like ultrasound
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or even MRI to see if there's erosions that is taking place
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that hasn't been quite picked up by an X-ray.
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So joint erosion is something that we all aim to prevent
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because what joint erosion implies is destruction of a joint.
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That joint won't function as it's intended to do
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over a chronic period of time, and that's when you start thinking about
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chronic morbidity, chronic pain, chronic disability,
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and in worst case scenarios, the end result means
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that you might need a joint replacement.
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But with early diagnosis and early treatment
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with the DMARDs that exist, we can prevent changes
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at the level of the bone, so not all patients with rheumatoid arthritis
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will develop erosions as long as they're treated early,
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they're treated adequately, their inflammation is kept in control.
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