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Rheumatic Diseases

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Fundamentals of Hand and Wrist Imaging

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Abstract

Inflammatory arthritis starts in the synovial membrane. The synovial membrane is composed of two layers: an external fibrous and an internal synovial layer. Whereas the first is a complex structure of collagen fibers with hardly any metabolic activity, the synovial layer with its high content of capillaries ensures a fast and extensive reaction to any kind of agent. It is arranged in folds covered by one or two layers of two types of lining cells: the A-cells and the B-cells. The so-called A-cells are derived from bone marrow and are capable of phagocytosis when presented with foreign material. The B-cells are special fibroblasts of mesenchymal origin and synthesize important proteins of the synovial fluid such as glycosaminoglycans. No basal layer separates these lining cells from the underlying synovial stroma that consists of a loose network of collagen fibers with many capillaries and a varying amount of fat cells. The synovium is an immunocompetent tissue and reacts to any agent according to general defense mechanisms (Fig.13.1) (Leeb et al.1996).

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  1. Herwig Imhof
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  2. Franz Kainberger
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  3. Irene Sulzbacher
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  4. Thomas Rand
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Editors and Affiliations

  1. IRCCS Hospital “Casa Sollievo della Sofferenza”, Viale Cappuccini, 71013, San Giovanni Rotondo, Italy

    Giuseppe Guglielmi MD

  2. Academic Medical Center, Department of Radiology, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Cornelis van Kuijk MD, PhD

  3. Department of Radiology, University of California at San Francisco, CA, 94143-0628, San Francisco, USA

    Harry K. Genant MD

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Imhof, H., Kainberger, F., Sulzbacher, I., Rand, T. (2001). Rheumatic Diseases. In: Guglielmi, G., van Kuijk, C., Genant, H.K. (eds) Fundamentals of Hand and Wrist Imaging. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-56917-3_13

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