If a patient with rheumatoid arthritis experiences increased joint inflammation despite NSAID treatment, which consequence follows from elevated intra-articular cytokine levels?

💡 Explanation

Increased intra-articular cytokines such as TNF-alpha stimulate osteoblasts to express RANKL, promoting osteoclast differentiation and bone resorption; because RANKL binds to RANK on osteoclasts, bone destruction accelerates in rheumatoid arthritis. Therefore, the correct answer is enhanced RANKL expression, rather than cartilage synthesis or osteoclast inhibition, which would alleviate inflammation.

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