Arthritis: The Disease of the Joints
Arthritis is a group of conditions involving damage to the joints of the body. There are different forms of arthritis and each has a different cause.
The most common form of arthritis, osteoarthritis (degenerative joint disease) is a result of trauma to the joint, infection of the joint, or age.
Other arthritis forms are rheumatoid arthritis and psoriatic arthritis, autoimmune diseases in which the body attacks itself.
Arthritis is a group of conditions involving damage to the joints of the body. There are different forms of arthritis and each has a different cause.
The most common form of arthritis, osteoarthritis (degenerative joint disease) is a result of trauma to the joint, infection of the joint, or age.
Other arthritis forms are rheumatoid arthritis and psoriatic arthritis, autoimmune diseases in which the body attacks itself.
Septic arthritis is caused by joint infection. Gouty arthritis is caused by deposition of uric acid crystals in the joint, causing inflammation. There is also an uncommon form of gout caused by the formation of rhomboid crystals of calcium pyrophosphate. This gout is known as pseudogout.
Physical Examination
All arthritides feature pain. Pain patterns may differ depending on the arthritides and the location.
Rheumatoid arthritis is generally worse in the morning and associated with stiffness; in the early stages, patients often have no symptoms after a morning shower.
In the aged and children, pain might not be the main presenting feature; the aged patient simply moves less, the infantile patient refuses to use the affected limb.
Important features of this disease are: speed and time of onset, pattern of joint involvement, symmetry of symptoms, early morning stiffness, tenderness, gelling or locking with inactivity, aggravating and relieving factors, and other systemic symptoms.
Physical examination may confirm the diagnosis, or may indicate systemic disease. Radiographs are often used to follow progression or assess severity in a more quantitative manner.
Blood tests and X-rays of the affected joints often are performed to make the diagnosis. Screening blood tests are indicated if certain arthritides are suspected. These might include: rheumatoid factor, antinuclear factor (ANF), extractable nuclear antigen, and specific antibodies.
Types of Arthritis
1. Osteoarthritis
Osteoarthritis (OA) is a group of diseases and mechanical abnormalities entailing degradation of joints, including articular cartilage and the subchondral bone next to it.
Clinical symptoms of OA may include joint pain, tenderness, stiffness, inflammation, creaking, and locking of joints. In OA, a variety of potential forces – hereditary, developmental, metabolic, and mechanical, may initiate processes leading to loss of cartilage.
The patient increasingly experiences pain upon weight bearing, including walking and standing. Due to decreased movement because of the pain, regional muscles may develop atrophy, and ligaments may become more lax. OA is the most common form of arthritis, and the leading cause of chronic disability.
2. Rheumatoid Arthritis
This is a chronic, systematic and serious inflamatory disorder that may affect many tissues and organs, but principally attacks the joints producing an inflammatorysynovitis that often progresses to destroy the articular cartilage and ankylosis of the joints.
It can also produce diffuse inflammation in the lungs, pericardium, pleur and sclera, and also nodular lesions, most common in subcutaneous tissue under the skin. Although the cause of rheumatoid arthritis is unknown, autoimmunity plays a pivotal role in its chronicity and progression.
About one percent of the world’s population is afflicted by rheumatoid arthritis, with women three times more often affected than men.
3. Septic Arthritis
Septic arthritis is the purulent invasion of a joint by an infectious agent which produces arthritis. The usual etiology of septic arthritis is bacterial, but viral, microbacterial and fungal arthritis occur occasionally.
A broader term is “infectious arthritis”, which describes arthritis caused by any infectious organism. Viruses can cause arthritis, but it can be hard to determine if the arthritis is directly due to the virus or if the arthritis is reactive.
4. Gout and Pseudogout
Gout is a disease hallmarked by elevated levels of uric acid in the bloodstream. In this condition, crystals of monosodium urate or uric acid are deposited on the articular cartilage of joints, tendons, and surrounding tissues.
It is marked by transient painful attacks of acute arthritis initiated by crystallization of urates within and about the joints and can eventually lead to chronic gouty arthritis and the deposition of masses of urates in joints and other sites, sometimes creating tophi.
5. Juvenile Idiopathic Arthritis (JIA)
JIA is the most common form of persistent arthritis in children. (Juvenile in this context refers to an onset before age 16, idiopathic refers to a condition with no defined cause, and arthritis is the inflammation of the synovium of a joint.)
JIA is a subset of arthritis seen in childhood, which may be transient and self-limited or chronic. It differs significantly from arthritis commonly seen in adults and other types of arthritis, and can present chronic conditions (e.g. Psoriatic arthritis and ankylosing spondylitis) in childhood.
6. Still’s Disease
The disease typically affects 16-35 year olds and presents with arthralgia, elevated serum ferritin, a ‘salmon-pink’ rash, pyrexia and lymphadenopathy. Rheumatoid factor and anti-nuclear antibody are classically negative.
Those experiencing a flare-up from Adult Onset Still’s Disease usually report extreme fatigue, swelling of the lymph glands, and less commonly fluid accumulation in the lungs and heart. A common ‘differential diagnosis’ for Still’s is Lyme disease.
Treatment for Adult-Onset Still’s disease is done with anti-inflammatory drugs. Cortisone medications (steroids) such as prednisone are used to treat severe symptoms of Still’s. Other medications include Plaquenil, Cuprimine, Imuran, Methotrexate, Embrel, Kineret, Cytoxin, Humira, Rituxan and Remicade.
7. Ankylosing Spondilitis
This is a chronic, inflammatory arthritis. It affects joints in the spine and the sacroilium in the pelvis, causing eventual fusion of the spine.
It is a member of the group of the spondyloarthropathies with a strong genetic predisposition. Complete fusion results in a complete rigidity of the spine, a condition known as bamboo spine.
Treatment of the Disease
Treatment options vary depending on the type of arthritis and include physical therapy, lifestyle changes (including exercise and weight control), medications and dietary supplements (symptomatic or targeted at the disease process causing the arthritis).
Arthroplasty (joint replacement surgery) may be required in eroding forms of arthritis. In general, studies have shown that physical exercising of the affected joint can have noticeable improvement in terms of long-term pain relief.
Furthermore, exercising of the arthritic joint is encouraged to maintain the health of the particular joint and the overall body of the person.
* Content from Wikipedia was used while writing this article.