For the first finger: Evidence of periarticular osteoporosis, with or without slight subchondral bone destruction; slight cartilage destruction is possible; joint mobility is possibly limited, but no joint deformities are observed; adjacent muscle atrophy is present; extra-articular soft tissue lesions (eg, nodules and tenosynovitis) are possible. In addition, It can affect other organ systems and cause inflammation there: the lungs, the eyes, a skin rash, and it can even affect the heart. Lumps on the elbows called rheumatoid nodules may also develop. (Keep in mind, though, that some people have what’s known as seronegative RA, in which blood tests don’t reveal antibodies like rheumatoid factor or anti-citrullinated protein antibodies, or anti-CCP.)
When it comes to imaging results, the second stage is more confirmative for the diagnosis. It has kind of a moth-eaten, chipped off appearance on the X-rays. Ultrasound can also be done, and the most sensitive is an MRI, which would pick up if there are any problems even if the X-ray is normal.
RA Stage III (severe progression) –
For the 3rd finger: Evidence of cartilage and bone destruction in addition to periarticular osteoporosis; joint deformity (eg, subluxation, ulnar deviation, or hyperextension), but in this case boutonniere deformity can be seen , without fibrous or bony ankylosis; muscle atrophy is extensive; extra-articular soft tissue lesions (eg, nodules, tenosynovitis) are possible.
In the end, we also have radial deviation of metacarpophalangeal joints.
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