Joint not involved in Rheumatoid ahritis according to 1987 ACR CLASSIFICATION CRITERIA ?
**Core Concept:**
Rheumatoid arthritis (RA) is a chronic inflammatory disorder primarily affecting the joints, particularly small joints in the hands and feet. The 1987 American College of Rheumatology (ACR) Classification Criteria aim to identify patients with RA for research and clinical purposes.
**Why the Correct Answer is Right:**
The correct answer, **Option D**, refers to the "elbow joint." This joint is not typically involved in RA due to its large size and limited range of motion, which makes it less susceptible to the synovial inflammation and erosive changes seen in RA.
**Why Each Wrong Option is Incorrect:**
**Option A**: The "ankle joint" is incorrect because it is not specifically mentioned in the 1987 ACR Classification Criteria, and its larger size and more stable structure make it less prone to RA involvement.
**Option B**: The "shoulder joint" is incorrect because it is less susceptible to RA due to its larger size, less frequent involvement in RA, and less severe disease course compared to smaller joints.
**Option C**: The "hip joint" is incorrect for similar reasons as the ankle joint and shoulder joint. Its larger size, less frequent involvement, and milder disease course make it less susceptible to RA.
**Clinical Pearl / High-Yield Fact**:
The 1987 ACR Classification Criteria for RA focus on small joints like the MCP (metacarpophalangeal) and PIP (proximal interphalangeal) joints in the hands and feet. They emphasize the presence of symmetric polyarthritis, morning stiffness, erosions, and the presence of rheumatoid factor (RF) or anti-citrullinated peptide antibodies (ACPA).
**Correct Answer**: **Option D**, "elbow joint", is correct because it is less susceptible to the typical RA involvement due to its larger size and limited range of motion. The 1987 ACR Classification Criteria primarily focus on small joints, and the elbow joint is not mentioned in the criteria.