RA-the Pacman- How does RA cause deformities?

August 1, 2010

I’m sure all of you know that Rheumatoid arthritis (RA) is an autoimmune disease,  which means that the body’s immunity considers its own joints as foreign & attacks them. We have not been able to pinpoint the exact reason for this.
If this immune attack is not controlled in time, it ends up destroying the joints. So what starts as joint pain & swelling can well end up as deformities & disabilities.

But then, how does RA cause these deformities?
The joint is lined by a thin membrane called the synovial membrane from the inside. The immune attack is targeted towards the synovial membrane. The synovial membrane swells up due to the attack & is called ‘the pannus’. This pannus is like the pacman. Remember the pacman game… pacman eats away all the dots. In a similar fashion, the pannus eats the cartilage & the bones around it. When it eats the bones, the same is known as erosion.
The RA pacman can go even further & damage the tendons outside the joints. Once the tendons are affected, joints get deformed.

The Pacman game.. Pacman keeps eating the dots…just like the RA pannus keeps eating the cartilage & the bones.

Note how the RA Pacman has destroyed the carpal bones in the wrist.

Note how the hip bone & the cartilage in the joints has been eaten up by the RA Pacman.

The resultant deformities—

Can these deformities be prevented?
Yes, very much so. Seeing a Rheumatologist at the earliest & starting DMARDs (Disease modifying anti-rheumatic drugs) at the earliest can definitely tame this pacman & prevent deformities.


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