Premium Nahrungsergänzungsmittel | artgerecht

Pannus – Causes, Symptoms and Treatment

Pannus is inflammatory granulation tissue that forms in joints, destroying cartilage and bone, most commonly in rheumatoid arthritis. Early treatment is essential.

Regular tips about health Regular tips about health

Things worth knowing about "Pannus"

Pannus is inflammatory granulation tissue that forms in joints, destroying cartilage and bone, most commonly in rheumatoid arthritis. Early treatment is essential.

What is Pannus?

Pannus (from Latin, meaning cloth or rag) refers to a pathological overgrowth of inflammatory granulation tissue. It most commonly develops within joints, where it spreads across the synovial membrane (joint lining) and invades cartilage and underlying bone. Pannus formation is a hallmark feature of rheumatoid arthritis and other chronic inflammatory joint diseases.

Causes and Development

Pannus tissue develops as a consequence of chronic inflammation of the synovial membrane, known as synovitis. In rheumatoid arthritis, the immune system mistakenly attacks the body's own joint lining, triggering a persistent inflammatory response. This process involves:

Proliferation of synovial cells (synoviocytes)
Infiltration of immune cells including macrophages, T-lymphocytes, and B-lymphocytes
Release of pro-inflammatory cytokines such as TNF-α and interleukin-1
Formation of new blood vessels (angiogenesis) within the tissue

The resulting pannus tissue is highly aggressive, secreting enzymes known as matrix metalloproteinases that degrade cartilage and erode bone.

Associated Conditions

Pannus formation occurs primarily in the following conditions:

Rheumatoid Arthritis (RA): The most common cause; pannus is responsible for the characteristic joint destruction seen in RA.
Psoriatic Arthritis: Inflammatory joint involvement associated with psoriasis.
Tuberculous Arthritis: Pannus can also arise in infectious (e.g., tuberculosis-related) synovitis.
Trachoma (Eye): In trachoma, a bacterial eye infection, pannus refers to the growth of blood vessels into the cornea, which can lead to vision impairment.

Symptoms

The symptoms caused by pannus depend on the affected organ. In joint disease, typical manifestations include:

Joint pain, especially pronounced in the morning (morning stiffness)
Swelling and warmth of affected joints
Restricted range of motion
Over time: joint deformities and permanent structural damage

In cases of ocular pannus, patients may experience visual disturbances or, in severe cases, loss of vision.

Diagnosis

Pannus tissue is identified using several diagnostic methods:

MRI (Magnetic Resonance Imaging): The most sensitive imaging method for early detection of pannus in joints.
X-ray: Reveals later-stage joint damage such as erosions and joint space narrowing.
Ultrasound: Can visualize synovial hypertrophy and pannus tissue.
Biopsy: Histological examination of tissue provides definitive confirmation.
Laboratory tests: Elevated inflammatory markers (CRP, ESR), rheumatoid factor, and anti-CCP antibodies support the diagnosis of the underlying disease.

Treatment

Treatment targets the underlying disease with the goal of suppressing inflammation and halting pannus progression:

Pharmacological Treatment

DMARDs (Disease-Modifying Antirheumatic Drugs): Foundational medications such as methotrexate that slow the course of rheumatoid arthritis.
Biologics: Targeted therapies such as TNF-α inhibitors (e.g., adalimumab, etanercept) or IL-6 inhibitors (e.g., tocilizumab) that block specific inflammatory mediators.
JAK Inhibitors: Newer oral agents that inhibit intracellular inflammatory signaling pathways.
Corticosteroids: Used for short-term anti-inflammatory relief, e.g., prednisolone.
NSAIDs (Non-Steroidal Anti-Inflammatory Drugs): For symptomatic pain and inflammation relief.

Non-Pharmacological Treatment

Physiotherapy to maintain joint function and mobility
Occupational therapy to support daily living activities
Surgical intervention (e.g., synovectomy -- surgical removal of the inflamed synovial membrane) in severe or refractory cases

References

Firestein GS, et al. - Kelley & Firestein's Textbook of Rheumatology, 10th Edition. Elsevier, 2017.
Smolen JS, et al. - Rheumatoid arthritis. Nature Reviews Disease Primers. 2018;4:18001. doi:10.1038/nrdp.2018.1.
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) - Rheumatoid Arthritis. Available at: www.niams.nih.gov

Building Blocks for a Healthy Life

As an integrated manufacturer, we develop & produce evidence-based, patented, and non-patented formulations. We work exclusively with plant and natural extracts according to the strictest purity & quality standards.
The combination of science & modern technology with the laws of nature creates solutions consistently tailored to humans – for the highest good: health.