RESUMEN
Background: Rheumatoid arthritis hardly causes diagnostic problems when presented typically. Generally, difficulties arise when atypical clinical presentation is related with non-contributory preliminary investigations. Arthritis is an important cause of morbidity. Methods: In this study 60 total numbers of cases were included. This study was conducted in the Department of Orthopedics in K M Medical College & Hospital, Mathura. The duration of study was over a period of one year. Result: This result revealed that 40% cases were suffering from Chronic non -specific synovitis, 31.6% Rheumatoid arthritis, 6.7% Septic Arthritis & Osteoarthritis, 5% Gout & Synovial (osteo) chondro mitosis,3.3% Synovial sarcoma, 1.6% Giant cell tumor of tendon sheath Conclusion: This study concludes that Diagnostic method like immune-histological methods can be used to eliminate the “non-specificity”. It is also useful in achieving a better specific diagnosis.
RESUMEN
Rheumatoid arthritis (RA) mainly affects polyarticular joints and is characterized by inflammation of the synovial membrane leading to joint destruction. We report on an unusual case of RA presenting as an intra-articular mass invading bone of the wrist joint in a patient with chronic monoarthritis. A 43-year-old man presented with left wrist joint pain and swelling lasting several years. A plain radiograph showed a non-specific osteolytic lesion in the distal ulna but a magnetic resonance image demonstrated an intra-articular irregular mass-like lesion with eccentric bone erosion the distal radioulnar joint. Synovial biopsy detected hyperplasia of the synovial lining cell layer and finger-like protrusions of inflamed and edematous fibrovascular stroma containing dense inflammatory infiltrates, mainly plasma cells, B cells, and CD4+ T cells. Rheumatoid factor and anti-citrullinated protein antibody were highly positive. The patient was diagnosed with RA and treated with disease-modifying anti-rheumatic drugs, showing a good response on further follow-up.