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Patient ReportsUnderstanding Pannus and Its Effects on the Joints
Written by Medicover Team and Medically Reviewed by Dr Bhavana Surapareddy , Rheumatologists
Table of Contents
Pannus is an abnormal growth of fibrovascular or granulation tissue that develops in response to chronic inflammation. It can occur in different parts of the body, including the joints, eyes, and around prosthetic heart valves. The effects depend on its location and underlying cause.
Pannus can interfere with normal tissue function and may cause pain, swelling, stiffness, irritation, or other problems. Early evaluation and treatment of the underlying condition can help prevent tissue damage and complications.
What are the Types of Pannus?
Pannus can develop in different locations and is associated with different underlying conditions.
- Pannus in Rheumatoid Arthritis: Chronic inflammation of the joint lining causes abnormal tissue to grow over cartilage and bone, potentially leading to joint damage, stiffness, and pain.
- Abdominal Pannus: An overhanging fold of excess skin and fatty tissue over the lower abdomen, commonly associated with significant obesity or weight changes. It may cause skin irritation, infections, and hygiene difficulties.
- Corneal Pannus: Abnormal blood vessels and fibrous tissue grow over the cornea due to chronic inflammation or irritation and may affect vision.
- Cardiac or Prosthetic Valve Pannus: Abnormal tissue growth around a prosthetic heart valve can interfere with valve movement and function.
What are the Symptoms of Pannus?
Symptoms depend on the location and severity of the pannus and the underlying condition causing it.
- Rheumatoid Arthritis Pannus: Joint pain, swelling, morning stiffness, reduced range of motion, and progressive joint damage.
- Abdominal Pannus: Discomfort, skin irritation, rashes, fungal or bacterial infections, unpleasant odor, and difficulty maintaining hygiene.
- Corneal Pannus: Eye redness, irritation, dryness, sensitivity to light, blurred vision, and, in severe cases, reduced vision.
- Cardiac or Prosthetic Valve Pannus: Shortness of breath, fatigue, chest discomfort, or symptoms related to impaired heart valve function.
What are the Causes of Pannus?
Pannus develops as a result of chronic inflammation or abnormal tissue responses. The causes vary depending on where the pannus occurs.
Rheumatoid Arthritis Pannus
In rheumatoid arthritis, the immune system attacks the lining of the joints, causing persistent inflammation. This promotes the growth of pannus tissue, which can gradually damage cartilage and bone.
Abdominal Pannus
Abdominal pannus is primarily associated with significant obesity, substantial weight gain, or major changes in body weight that result in excess skin and fatty tissue around the lower abdomen.
Corneal Pannus
Corneal pannus may develop from chronic eye inflammation or irritation, including conditions such as keratitis, trachoma, and prolonged or improper contact lens use.
Prosthetic Valve Pannus
Pannus around a prosthetic heart valve can develop as a chronic tissue response following valve replacement and may gradually interfere with valve function.
When to See a Doctor for Pannus?
Consult the appropriate specialist if symptoms of pannus affect the joints, abdomen, eyes, or heart. Depending on the location, care may involve a rheumatologist, orthopedic specialist, ophthalmologist, general surgeon, or cardiologist.
- Persistent joint pain, swelling, or stiffness
- Excess abdominal tissue with persistent irritation or recurrent skin infections
- Eye redness, irritation, or blurred vision
- Shortness of breath, fatigue, or other symptoms after prosthetic heart valve replacement
Get medical help immediately if:
- Sudden or severe loss of vision
- Severe breathing difficulty or chest discomfort
- Rapidly worsening joint symptoms or inability to move the affected joint
- Signs of a serious skin infection, such as spreading redness, swelling, or fever
These symptoms may indicate significant tissue damage, infection, or another underlying condition requiring prompt medical evaluation.
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How Is Pannus Diagnosed?
Diagnosis depends on the location of the pannus and the suspected underlying cause. Doctors typically combine a medical history, physical examination, and appropriate imaging or specialized tests.
Rheumatoid Arthritis Pannus
Clinical examination, blood tests, X-rays, and MRI may be used to identify inflammation, pannus formation, and joint damage. Blood tests may also help identify rheumatoid arthritis and other inflammatory conditions.
Abdominal Pannus
Abdominal pannus is usually diagnosed through physical examination. Imaging such as ultrasound or CT scans may be used when the extent of tissue or underlying structures needs further assessment.
Corneal Pannus
An ophthalmologist can diagnose corneal pannus through a comprehensive eye examination. Slit-lamp examination helps visualize the cornea and assess the extent of abnormal blood vessel and tissue growth.
Prosthetic Valve Pannus
Doctors may use echocardiography and other cardiac imaging tests to evaluate prosthetic valve function and determine whether abnormal tissue is interfering with blood flow.
What are the Treatment Options for Pannus?
Treatment depends on the location, severity, and underlying cause of pannus. The main goals are to control inflammation, prevent further tissue damage, and manage symptoms.
Rheumatoid Arthritis Pannus
- Medications: NSAIDs, corticosteroids, disease-modifying antirheumatic drugs (DMARDs), and biologic medicines may be used to control inflammation and prevent joint damage.
- Physical Therapy: Exercises can help maintain joint mobility, muscle strength, and function.
- Surgery: Severe joint damage may require procedures such as synovectomy or joint replacement.
Abdominal Pannus
- Weight Management: A healthy diet and regular physical activity can help reduce excess body fat.
- Skin Care: Proper hygiene and appropriate topical treatments can help prevent irritation and infection in skin folds.
- Panniculectomy: Surgery to remove excess skin and fatty tissue may be considered when the pannus causes significant functional problems or recurrent complications.
Corneal Pannus
- Medications: Treatment may include prescribed eye drops or other medicines to control inflammation or infection.
- Contact Lens Modification: Avoiding prolonged or improper contact lens use can help reduce ongoing irritation.
- Surgery: Advanced cases with significant corneal involvement may require surgical treatment, depending on the underlying cause and extent of damage.
Prosthetic Valve Pannus
When pannus significantly interferes with prosthetic valve function, cardiac evaluation is necessary. In severe cases, surgical intervention may be required to restore appropriate valve function.
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What are the Risk Factors of Pannus?
Risk factors depend on the type of pannus and the condition causing it.
- Chronic inflammatory or autoimmune diseases such as rheumatoid arthritis
- Significant obesity or major changes in body weight
- Chronic eye inflammation or irritation
- Prolonged or improper contact lens use
- Previous prosthetic heart valve replacement
What are the Complications of Pannus?
Untreated or progressive pannus can cause complications depending on its location and underlying cause.
- Joint Damage: Rheumatoid arthritis-related pannus can progressively damage cartilage and bone.
- Skin Problems: Abdominal pannus can cause recurrent irritation, rashes, fungal infections, and bacterial infections.
- Vision Problems: Corneal pannus can interfere with the cornea and may affect vision.
- Heart Valve Dysfunction: Prosthetic valve pannus can restrict valve movement and impair blood flow.
How Can Pannus Be Prevented?
Prevention depends on the type of pannus and focuses mainly on controlling the conditions that contribute to abnormal tissue growth.
- Seek early treatment and maintain control of inflammatory conditions such as rheumatoid arthritis.
- Maintain a healthy weight through a balanced diet and regular physical activity.
- Follow appropriate eye care and avoid prolonged or improper contact lens use.
- Attend regular follow-up appointments after prosthetic heart valve replacement.
- Follow prescribed treatment plans to reduce chronic inflammation and prevent complications.
Frequently Asked Questions
1. What is pannus formation?
Pannus is an abnormal layer of inflamed fibrovascular tissue that develops over a surface. It is commonly associated with rheumatoid arthritis, where it can form inside joints and damage cartilage and bone.
2. What are the symptoms of pannus in rheumatoid arthritis?
Symptoms may include joint pain, swelling, stiffness, reduced range of motion, warmth, and progressive joint damage. The severity depends on the underlying rheumatoid arthritis.
3. How is pannus treated?
Treatment focuses on controlling the underlying condition, particularly rheumatoid arthritis, using disease-modifying antirheumatic drugs (DMARDs), biologic medicines, and other anti-inflammatory treatments. Surgery may be considered for severe joint damage.
4. What is an abdominal pannus?
An abdominal pannus, also called a panniculus, is an overhanging fold of excess skin and fatty tissue in the lower abdomen. It may occur after significant weight loss, pregnancy, or obesity and can cause skin irritation or infections.
5. How is pannus diagnosed?
Diagnosis depends on the type of pannus. Physical examination and medical history are often sufficient, while X-rays, ultrasound, MRI, or other imaging tests may be used to assess joint pannus and underlying tissue damage.
6. Can pannus formation be prevented?
Pannus associated with rheumatoid arthritis may be reduced by early diagnosis and effective control of joint inflammation. An abdominal pannus can sometimes be reduced through weight management, although excess skin may remain after major weight loss.
7. Is pannus formation serious?
Joint pannus can be serious because persistent inflammation may damage cartilage, bones, and joint function. An abdominal pannus is generally not dangerous but may cause discomfort, skin problems, and difficulty with movement or hygiene.
