[Progression of bone and articular destruction and QOL].

The joint dysfunction caused by bone and articular destruction is the most important pathology in rheumatoid arthritis (RA) patients. The progression of bone and articular destruction starts within five years from disease onset, however depending each case inflammation. Quality of life (QOL) of RA patients needs early stage treatment to prevent joint destruction. We recognized villonodular synovial proliferation is significantly correlated with early stage RA. Therefore to decrease those synovium leads to prevent joint destruction. Biological therapy itself can not inhibit villonodular synovial proliferation in effect attenuation cases. Arthroscopical synovectomy is effective to remove those synovium and restore the effect of biological therapy. It is needed that detail analysis of improvement of joint destruction by biological therapy near future to lead the improvement QOL of RA patients.