Reumatoscience

Decades after Alfred Baring Garrod coined the term #rheumatoid #arthritis (RA), in 1905 and 1909, Edward H. Nichols and Frank L. Richardson in their works published in the Journal of Medical Research and in The Boston Medical and Surgical Journal, respectively, made one of the best clinicopathological descriptions of #rheumatic diseases and and differentiated for the first time 2 groups of patients, one that described clinical characteristics similar to RA and the other with characteristics of #osteoarthritis. Although the 2 articles by Nichols and Richardson refer to cases of “non-scrofulous deforming arthritis”, the detailed representation of the clinical picture, accompanied by photos, drawings and radiographic images, clearly tells us about cases of RA. These authors also collected a series of histological samples from 75 clinical cases and reached an important conclusion: there are two histological patterns of joint involvement, one of deterioration of the articular #cartilage and another of thickening of the #synovial membrane; the latter is closely related to the invasion of #bone tissue and articular cartilage, causing destruction and, occasionally, disorganized bone neoformation. In this same publication by Nichols and Richardson, proliferative arthritis is described with the formation of a highly #vascularized granulation tissue, with a cellular component of #mesenchymal origin mainly from the synovial membrane, which they called “#pannus-like tissue”. This is the first time that the term articular pannus was used. It is important to note that the term pannus was already used at that time to describe certain types of corneal lesions in ophthalmology. It is defined by the American Academy of Ophthalmology as a growth of fibrous and vascular tissue between the epithelium and Bowman's layer, frequently seen in cases of chronic corneal edema, following inflammation of the cornea. Both synovial pannus and corneal pannus described lesions similar to a "cloth", which is the literal translation from English. 📸 Microphotograph of one of Nichols and Richardson's patients showing a joint with a pannus composed of a very vascular granulation tissue infiltrated with lymphoid and plasma cells with comparatively little intercellular fibrillar material. 📸 Drawing of the autopsy of a 40-year-old woman with symptoms of polyarthritis of large and small joints that caused great disability and ankylosis. The loss of articular cartilage and bone formation areas that cause ankylosis of the knee is evident. *Nichols EH, Richardson FL. Arthritis Deformans. J Med Res. 1909;21(2):149-222.51. 🔗pmc.ncbi.nlm.nih.gov/article…