Rheumatoid arthritis, an autoimmune disease of unknown cause, is the most crippling form. Women are much more susceptible to it than men. Although rheumatoid arthritis usually appears between the ages of 25 and 50, it also occurs in children. Osteoarthritis, the most common type, occurs usually in people over 50. It tends to be more severe when the joints have been strained by obesity or overwork. Gout, the third most common form of arthritis, affects men almost exclusively.
Symptomatic treatment for arthritis includes use of heat, physical therapy, and nonsteroidal anti-inflammatory drugs such as a cox-2 inhibitor (Celebrex), aspirin, ibuprofen, and naproxen. Remission of symptoms can sometimes be achieved with methotrexate, gold salts, penicillamine, and short-term cortisone, but they often have undesirable side effects. Orthopedic surgery, including artificial joint implantation, may be done in severe cases.
Acute inflammation of one or more joints caused by infection. Suppurative arthritis may follow certain bacterial infections; joints become swollen, hot, sore, and filled with pus, which erodes their cartilage, causing permanent damage if not promptly treated by giving antibiotics, draining the pus, and resting the joint. Nonsuppurative arthritis can accompany several diseases caused by bacteria, viruses, or fungi; joints become stiff, swollen, and painful to move. Treatment includes rest, drugs, and, in the case of tuberculosis, orthopedic care to prevent skeletal deformity.
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Chronic, progressive autoimmune disease causing connective-tissue inflammation, mostly in synovial joints. It can occur at any age, is more common in women, and has an unpredictable course. It usually starts gradually, with pain and stiffness in one or more joints, then swelling and heat. Muscle pain may persist, worsen, or subside. Membrane inflammation and thickening scars joint structures and destroys cartilage. In severe cases, adhesions immobilize and deform the joints, and adjacent skin, bones, and muscles atrophy. If high-dose aspirin, ibuprofen, and other NSAIDs do not relieve pain and disability, low-dose corticosteroids may be tried. Physical medicine and rehabilitation with heat and then range-of-motion exercises reduce pain and swelling. Orthopedic appliances correct or prevent gross deformity and malfunction. Surgery can replace destroyed hip, knee, or finger joints with prostheses. There is also a juvenile form of the disease.
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Inflammation of the joints and its effects. Acute arthritis is marked by pain, redness, and swelling. The principal forms are osteoarthritis, rheumatoid arthritis, and septic arthritis. Several forms of arthritis are part of the symptom complexes of autoimmune diseases.
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There are different forms of arthritis; 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. Emerging evidence suggests that abnormal anatomy might contribute to the early development of osteoarthritis. 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.
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.
Elements of the history of the disorder guide diagnosis. Important features 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.
|Extra-articular features of joint disease|
|cutaneous vasculitic lesions|
|tenosynovitis (tendon sheath effusions)|
|bursitis (swollen bursa)|
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.
Secondary to other diseases:
Diseases that can mimic arthritis include:
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.
Another form of non-drug treatment that does have a body of proper research to support its efficacy is marine oil, from both fish and the New Zealand green-lipped mussel (Perna canaliculus). Diets high in marine oils from cold-water fish such as salmon, mackerel, and tuna have been shown to reduce the inflammation of joint conditions such as arthritis. Massage on joints with neem oil has reported improvement in chronic and acute cases.
In 1715 William Musgrave published the second edition of his most important medical work De arthritide symptomatica which concerned arthritis and its effects.