The onset of rheumatoid arthritis is an inflammatory process. With joint inflammation, the synovium thickens. Synovial cells increase in number during the thickening stage. The synovium becomes edematous (fluid-filled) and enriched with new blood vessel formation. Synovial fluid production increases and the joint capsule swells along with these changes. Circulating inflammatory cells infiltrate the joint tissue. The cellular processes that occur during inflammation and the resulting changes are referred to as active synovitis. With active synovitis, irritation and swelling of the joint lining, degradation of cartilage, and bone erosions can occur.
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