About Inflammatory Arthritis
Formerly known as malignant fibrous histiocytoma (MFH), a pleomorphic sarcoma is a tumor of the soft tissue and bone that is categorized as having an undifferentiated or unspecific origin. Like all soft tissue tumors, this is a rare diagnosis in Los Angeles, but accounts for many sarcoma diagnoses among older patients between the ages of 50 and 70. It is a malignant (cancerous) tumor that usually develops in the extremities and the region inside the abdomen known as the retroperitoneal space. Metastasis (spread) of this type of cancer is most common to the lungs, bones, and liver.
A diagnosis performed by a professional oncologist, such as Dr. Allison located in Los Angeles, of undifferentiated pleomorphic sarcoma (UPS) is also what is known as a diagnosis of exclusion, meaning that a precise or more specific diagnosis of the origin of the tumors is inconclusive or unclear. Pleomorphic sarcoma tumors do not resemble any type of normal tissue when examined under a microscope.
The histology of a UPS (how the tumor appears when observed under a microscope, and its behavior) can resemble other specifically differentiated types of sarcoma tumors, most commonly:
- Giant cell
- Storiform pleomorphic (the most common cell type in an undifferentiated pleomorphic sarcoma, accounting for approximately 70%)
Pleomorphic sarcomas tend to contain a large number of a type of immune cell known as a histiocyte (or macrophage). Unlike other immune cells, histiocytes remain static in a specific part of the body and do not travel beyond their original site. They can be found in a number of organs like the brain, liver, lymph nodes, breast tissue, tonsils, spleen, and placenta.
What Is Rheumatoid Arthritis?
Rheumatoid arthritis is an inflammatory disease in which the body’s immune system attacks the synovial membrane or the lining of the joints in the hands and feet. In some cases, other parts of the body may be affected by RA, including the eyes, skin, blood vessels, and lungs. The disease typically occurs after age 40 and overwhelmingly affects women more than men.
The symptoms of RA may occur in waves of increased disease activity known as flare ups, and include the following:
- Warm, swollen joints
- Stiff joints, particularly during the morning hours
- Weight loss
- Bumps under the skin of the arms (rheumatoid nodules)
If left untreated, RA, as with other autoimmune inflammatory disorders, can cause the joints to degenerate and deform, making movement both painful and difficult.
Treating Inflammatory Arthritis
While there is no one-size-fits-all cure for inflammatory diseases such as RA, it is possible to reduce the painful side effects. Initially, treatment begins with conservative options, such as pain medication, anti-inflammatory drugs, disease-modifying anti-rheumatic drugs (DMARDs), and physical therapy to preserve joint flexibility.
When conservative methods fail to alleviate the symptoms and joint damage of RA, surgery may help reduce pain and restore movement and function.
Surgical options for RA include:
Tendon Repair – Inflammation around the small joints of the hands, wrists, and feet can cause the tendons to loosen or break. It is possible to surgically repair and reconstruct the tendons to preserve function and prevent further damage or immobility.
Joint Fusion – In some cases, it may be necessary to fuse certain joints together to stabilize and align the bones. Fusing the bones together can alleviate pain and may be an ideal alternative to total joint replacement.
Total Joint Replacement – The damaged cartilage and joint tissue is removed and replaced with a custom plastic and metal prosthesis. Joint replacement is often reserved as a last option after conservative methods such as pain management and therapy have failed.
Read more about inflammation and arthritis from cdc.gov.
Inflammatory Arthritis Diagnosis
Doctors diagnose osteoarthritis by speaking with the patient regarding their medical history, physical exam, diagnostics including imaging tests of the affected area and performing lab tests such as:
X-Ray – Reveals cartilage loss indicated by narrowing of space between bones and joints, bone spurs around a joint.
MRI – Shows detailed images of bone and soft tissues, including cartilage.
Blood Tests – Rule out other causes of joint pain, including rheumatoid arthritis.
Joint Fluid Analysis – Examines and tests joint fluid to determine cause of pain.