The pathogenesis of these inflammatory and degenerative joint diseases is a complex process, involving synovial cell proliferation, fibrosis and cartilage and bone erosion. This process is mediated by an interdependent network of cytokines, prostanoids and proteolytic enzymes.

Pro-inflammatory cytokines, such as interleukin-1 (IL-1) and tumour necrosis factor-alpha (TNF-α), are central mediators in joint inflammation. IL-1 concentrations in the plasma have been reported to correlate with disease activity. It has also been demonstrated that patients with erosive joint disease have higher synovial and circulating levels of IL-1 than patients without erosions.

According to the revised treatment guidelines established by the American College of Rheumatology, the ultimate goal in managing inflammatory and degenerative joint diseases is to:

The aim of treatment should be to improve functionality and health-related quality of life, in addition to relieving the signs and symptoms of MSC.