What is the primary pathophysiologic change in rheumatoid arthritis?

The primary pathophysiologic change in rheumatoid arthritis is that it is an autoimmune condition. In rheumatoid arthritis, the body's immune system mistakenly targets and attacks the synovial membrane, which lines the joints. This immune response leads to inflammation, pain, and swelling in the affected joints. Over time, chronic inflammation can result in the destruction of cartilage and bone, leading to significant joint deformities and functional impairment.

Understanding rheumatoid arthritis as an autoimmune condition is crucial because it highlights the underlying mechanism that drives the disease. Effective treatment strategies often focus on modulating the immune response to reduce inflammation and prevent joint damage, rather than solely addressing symptoms or complications that arise from the mechanical aspects of the disease.

In contrast, the other options involve different mechanisms. Degenerative changes refer to osteoarthritis, which involves the wear and tear of joint structures over time rather than an immune response. Infection is not a typical characteristic of rheumatoid arthritis, as the disease isn't caused by pathogens. Similarly, overuse injury pertains to conditions resulting from repetitive strain on joints and tissues, differing significantly from the autoimmune nature of rheumatoid arthritis.