类风湿关节炎 Rheumatoid Arthritis (RA).pptVIP

History :Pierre-Auguste Renoir (1841-1919) * 5-C-19 Rheumatoid arthritis: subcutaneous nodule, olecranon鹰嘴　 A large subcutaneous nodule is located on the extensor surface of the forearm near the elbow. Rheumatoid nodules may be fixed or movable and are usually nontender. They occur most commonly at the elbow but may also be found on the feet, fingers, occiput, heels, and buttocks. Nodules occur in about 20% of patients with rheumatoid arthritis and are usually associated with high titers of rheumatoid factor. Subcutaneous nodules are also seen in other conditions such as systemic lupus erythematosus and mixed connective tissue disease. * 5-R-21 Rheumatoid arthritis: pulmonary nodules (roentgenogram) Large nodules are seen in the pulmonary parenchyma bilaterally. These nodules are discrete and similar in appearance to opacities caused by metastatic disease. They are histologically identical to subcutaneous rheumatoid nodules. * Rheumatoid arthritis: subcutaneous nodule, early (photomicrograph) Fibrinoid necrosis in vascular walls is present in the early stages of subcutaneous nodule formation. Surrounding tissue contains fibrinoid material and a primarily mononuclear inflammatory cell infiltrate. It has been suggested that the subcutaneous nodule has its inception in such foci of vascular damage (hematoxylin-eosin, medium power). * Rheumatoid arthritis: scleromalacia perforans This eye demonstrates several rheumatoid scleral nodules, scleral thinning, and adjacent conjunctival injection. The uveal tissue is about to herniate through the softened sclera in the midsuperior portion of the eye, which could result in a perforation of the globe. 5-C-17 Rheumatoid arthritis: scleromalacia perforans, herniation This eye demonstrates marked scleral thinning and adjacent scleral and conjunctival injection. The darker pigmented uveal tissue has herniated through the softened sclera, and perforation is imminent. Note the nonconcentric pupil. * Rheumatoid arthritis: v