arthritis, painful inflammation of a joint or joints of the body, usually producing heat and redness. There are many kinds of arthritis. In its various forms, arthritis disables more people than any other chronic disorder. The condition can be brought about by nerve impairment, increased or decreased function of the endocrine glands, or degeneration due to age. Less frequently, it is caused by infection (tuberculosis, gonorrhea, Lyme disease, rheumatic fever).

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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Arthritis (from Greek arthro-, joint + -itis, inflammation; plural: arthritides) is a group of conditions involving damage to the joints of the body. Arthritis is the leading cause of disability in people older than fifty-five years.

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.

History and 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.

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 nodules
cutaneous vasculitic lesions
lymphadenopathy
oedema
ocular inflammation
urethritis
tenosynovitis (tendon sheath effusions)
bursitis (swollen bursa)
diarrhea
orogenital ulceration

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

Primary forms of arthritis:

• Osteoarthritis
• Rheumatoid arthritis
• Septic arthritis
• Gout and pseudogout
• Juvenile idiopathic arthritis
• Still's disease
• Ankylosing spondylitis

Secondary to other diseases:

• Lupus erythematosus
• Henoch-Schönlein purpura
• Psoriatic arthritis
• Reactive arthritis
• Haemochromatosis
• Hepatitis
• Wegener's granulomatosis (and many other vasculitis syndromes)
• Lyme disease
• Familial Mediterranean fever
• Hyperimmunoglobulinemia D with recurrent fever
• TNF receptor associated periodic syndrome
• Inflammatory bowel disease (Including Crohn's Disease and Ulcerative Colitis)

Diseases that can mimic arthritis include:

• Hypertrophic osteoarthropathy
• Multiple myeloma
• Osteoporosis
• Fifth disease

Treatment

Treatment options vary depending on the type of arthritis and include physical and occupational 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.

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.

History

While evidence of primary ankle (kaki) osteoarthritis has been discovered in dinosaurs, the first known traces of human arthritis date back as far as 4500 BC. It was noted in skeletal remains of Native Americans found in Tennessee and parts of what is now Olathe, Kansas. Evidence of arthritis has been found throughout history, from Ötzi, a mummy (circa 3000 BC) found along the border of modern Italy and Austria, to the Egyptian mummies circa 2590 BC .

In 1715 William Musgrave published the second edition of his most important medical work De arthritide symptomatica which concerned arthritis and its effects.

References

See also

• Arthritis Care (charity in the UK)
• Osteoimmunology

External links

• American College of Rheumatology - US professional society of rheumatologists
• Arthritis Foundation - US national not-for-profit organization for arthritis