CHORUS

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Musculoskeletal system

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rheumatoid arthritis: joint manifestations

early signs:
• fusiform periarticular soft tissue swelling (result of effusion)
• regional osteoporosis (disuse and local hyperemia)
• widened joint space
• marginal + central bone erosion (base of 4th proximal phalanx most common)
• change in ulnar styloid and distal radioulnar joint
• atlantoaxial dislocation
• giant synovial cysts

late signs:
• flexion/extension contractures with ulnar subluxation/dislocation
• destruction/fusion of joints
• elevation of humeral heads (tear/atrophy of rotator cuff)
• resorption of distal clavicle
• erosion of superior margins of posterior portions of 3-5th ribs
• destruction/narrowing of disc spaces
• destruction of zygapophyseal joints without osteophyte formation
• resorption of spinous process
• protrusio acetabuli (from osteoporosis)

Related CHORUS documents: sacroiliitis absent distal clavicle ulnar styloid erosions atlantoaxial subluxation psoriatic arthritis ankylosing spondylitis

Copyright © 2013, Charles E. Kahn, Jr.