Arteriographic appearances in rheumatoid arthritis and other disorders

Abstract

Brachial arteriography has been performed on 67 patients; 42 with rheumatoid arthritis, 10 with primary Raynaud''s phenomenon and a number with other disorders, including 3 with polyarteritis nodosa. In the patients with rheumatoid arthritis 2 types of vascular lesion were demonstrated: occlusion and hyperemia. Occlusive lesions were often associated with clinical evidence of digital ischemia, subcutaneous nodules, a positive D.A.T., peripheral neuropathy and evidence of visceral involvement. They are more common in digits affected by erosive bone disease and were relatively commoner in men. No relation could be found between occlusive lesions, the age of the patient, the duration of rheumatoid arthritis or previous steroid therapy. Hyperemic lesions appear to represent vascular synovium in Joint and tendon sheath or granulation tissue in bone erosions or cysts. Many of the patients with Raynaud''s phenomenon showed occlusive lesions, especially when associated with some other disease. The arteriographic appearance in 3 patients with polyarteritis nodosa, showed, in addition to vascular occlusion, a network of irregular, tortuous, abnormal arteries, a pattern which may be characteristic of the condition.