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Arthritis and Rheumatism

Is There Joint Damage if the Person with RA has Swelling?

01/07/2008

Question:

A friend of mine said that she read some where that if a person with RA has swelling, it means that there is joint damage. I know that this will eventually happen. My hands and feet have been swollen since early October. My Enbrel stopped working. I am also trying to tapper off Prednisone. Is what she read true and how long would a person have to be swollen to get joint damage?

Answer:

The big assumption one needs to make in your case is that the swelling you describe is inflammation of the synovium (joint lining). If so, then there certainly is a risk that the synovial membrane could invade and destroy cartilage and the bone near the joint. However, the swelling that one observes is not always synovial inflammation. It may be swelling of nonsynovial tissue related to another process.

As far as rapidity of joint damage, one way to measure this is by scoring certain features related to Rheumatoid Arthritis (RA) on an x-ray. In one study, up to 90% of an RA study population had bone erosions identified on x-ray within the first two year of disease.1

1. Lindqvist E, Jonsson K, Saxne T, Eberhardt K. Course of radiographic damage over 10 years in a cohort with early rheumatoid arthritis. Ann Rheum Dis 2003;62:611-6.

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Response by:

Raymond  Hong, MD, MBA, FACR Raymond Hong, MD, MBA, FACR
Formerly, Assistant Professor of Medicine
School of Medicine
Case Western Reserve University