Neurological features

There are several neurological features of RA. The most common is nerve entrapment, the best example of which is carpal tunnel syndrome. Cervical myelopathy is a further example, which develops due to synovitis involving the cervical spine. These types of nerve entrapment occur due to local factors and are not limited to those with sero-positive disease. Other neurological features, occur as 'classical' extra-articular features in seropositive

Nodules at the elbow

Figure 1.6.

cases, and are often associated with vasculitis of the blood vessels supplying nerves. This vasculitis results in neurovascular disease, which can range from mild sensory neuropathy to severe sensorimotor neuropathy. Cases at the severe end of the spectrum are often termed 'mononeuritis multiplex', as multiple peripheral nerves are involved. Marked vascular damage can be seen in nerve biopsies in this condition.

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