Biochemical markers of synovium, cartilage and bone in rheumatoid arthritis

Abstract

Rheumatic diseases were first recognized by Hippocrates in the fourth century B.C. The term and#8213;rheumaand#8214; indicates continuous flow of pain through the different joints of the body. Goemaere et al1 reported the appearance and distribution of lesions in ancient skeletons suggesting that rheumatoid arthritis may have existed in North America at least 3000 years ago. The first clinical description of rheumatoid arthritis is credited to Augustin-Jacob Landre Beauvais (1800) in his thesis.2 Introduction Rheumatoid arthritis (RA) is a chronic, inflammatory systemic disease of unknown etiopathogenesis. It is one of the commonest autoimmune diseases.3 The major characteristic feature is the chronic, erosive synovitis of peripheral joints due to the uncontrolled proliferation of synovial tissue which leads to severe joint destruction.2 In addition to early disability and premature mortality, symmetric swelling of peripheral joints is the hallmark of the disease.4 Symptoms of Rheumatoid arthritis The symptoms of rheumatoid arthritis mainly involving the joints; typically affected are those of the hands, wrists, knees and feet. The synovial joint inflammation which leads to cartilage destruction, bone erosions and joint deformities is the important aspect of rheumatoid arthritis. The characteristic feature of the disease is experiencing pain, warmth, swelling, tenderness, stiffness and limitation of motion.5,6 Extra-articular involvement is another feature of RA and this can range from rheumatoid nodules occurring most commonly over bony prominences to life-threatening heart nodules and vasculitis.7 The course of rheumatoid arthritis can be quite variable, and can differ in different patients. Some RA patients may experience only a mild illness for brief duration involving one or two joints with minimal joint damage, whereas others may have a relentless progressive polyarthritis with noticeable functional impairment and disability.2 Rheumatoid arthritis is also associated with symptoms of fatigue, pain, and sleep