Which chronic disease involves inflammation and destruction of the synovial membranes of the joints, with cartilage and bone erosion, and may present as juvenile rheumatoid arthritis in children?

• A. Hay fever
• B. Rheumatoid arthritis
• C. Systemic lupus erythematosus
• D. Pernicious anemia

Answer: (B)

This question focuses on a chronic autoimmune inflammatory disease of the joints in which the synovial membranes become inflamed and progressively destroy cartilage and bone. That pattern of synovial inflammation with joint erosion is characteristic of rheumatoid arthritis, and in children it can present as juvenile idiopathic arthritis.

In rheumatoid arthritis, the immune system targets the synovium, leading to synovitis and the formation of inflammatory tissue called pannus. This pannus invades and damages cartilage and underlying bone, causing persistent pain, swelling, stiffness, and eventual joint deformities. The condition is often symmetric and frequently affects small joints of the hands and feet, and it can begin in childhood as a juvenile form.

The other options don’t fit this description as well. Hay fever involves allergic inflammation of the nasal passages, not joints. Systemic lupus erythematosus can involve joints but arthritis there is typically nonerosive and occurs with a broader set of systemic features. Pernicious anemia is a vitamin B12 deficiency affecting blood and nerves, not a joint inflammation disorder.