[The disease picture in rheumatoid arthritis as a result of different pathomechanisms]

Abstract

Even though rheumatoid arthritis is by definition an inflammatory disease, the complex picture of rheumatoid arthritis really owes its development to three completely different pathogenetic mechanisms, namely: Exudative-proliferative processes in the synovial tissue of joints and tendon sheaths and at serous skins; Destruction of articular cartilage and juxta-articular bone by the aggression of non-inflammatory tumor-like cell elements of synovial origin; Primary, non-inflammatory tissue necroses due to infiltration of immune complexes and complement. It is therefore understandable that all therapeutic approaches which have an antiphlogistic character can only influence pain, swelling and morning stiffness, but not the destruction of the joints and the primarily necrotising processes, which can also destroy vital structures in the heart and vessels.