Unilateral Rheumatoid Arthritis following Hemiplegia

Denervation protects limbs from inflammatory arthritis via an impact on the microvasculature

“…As early as 1935, it was reported that patients who suffered a stroke and then developed rheumatoid arthritis (RA), often years after the neurologic insult, had an atypical disease presentation: Instead of the inflammatory symmetry typical of RA, only neurologically intact limbs developed joint inflammation (6). Later, this effect of central denervation was extended to peripheral denervation: Patients who were hemiplegic subsequent to polio or syphilis developed an analogous asymmetric arthritis (7,8).…”

Atypical Presentations of Rheumatoid Arthritis

“…The protective effect on the affected side is less if a neurological deficit develops in a patient who already as RA 10 . Physical trauma in the preceding 6 months is significantly associated with the onset of RA 11 .…”

Symmetrical joint involvement.

“…Looking in this way at the 4 cases of rheumatoid arthritis starting in established hemiplegia described by Thompson and Bywaters (1962), all 4 showed 0% symmetry by these clinical criteria despite the total number ofjoints involved ranging from 7-14. …”