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Arthritis

What is arthritis?

Arthritis is a joint disorder featuring inflammation. A joint is an area of the body where two different bones meet. A joint functions to move the body parts connected by its bones. Arthritis literally means inflammation of one or more joints.

Arthritis is frequently accompanied by joint pain. Joint pain is referred to as arthralgia. When four or more joints are involved, the arthritis is referred to as polyarthritis. When two or three joints are involved, it is referred to as oligoarthritis. When only a single joint is involved, it is referred to as monoarthritis.

 

How many types of arthritis exist?

There are many types of arthritis (over 100 identified, and the number is growing). The types of arthritis range from those related to wear and tear of cartilage (such as osteoarthritis) to those associated with inflammation resulting from an overactive immune system (such as rheumatoid arthritis). Together, the many types of arthritis make up the most common chronic illness in the United States.

 

What causes arthritis?

The causes of arthritis depend on the form of arthritis. Causes include injury (leading to osteoarthritis), metabolic abnormalities (such as gout and pseudogout), hereditary factors, the direct and indirect effect of infections (bacterial and viral), and a misdirected immune system with autoimmunity (such as in rheumatoid arthritis and systemic lupus erythematosus).

Arthritis is classified as one of the rheumatic diseases. These are conditions that are different individual illnesses, with differing features, treatments, complications, and prognoses. They are similar in that they have a tendency to affect the joints, muscles, ligaments, cartilage, and tendons, and many have the potential to affect other internal body areas.

 

What are risk factors for arthritis?

The major risk factors for most forms of arthritis are genes that are inherited from ancestors. Trauma-related arthritis is related to the risk of injury from specific activities.

Symptoms of arthritis include pain and limited function of joints. Joint inflammation from arthritis is characterized by joint stiffness, swelling, redness, pain, and warmth. Tenderness of the inflamed joint can be present with or without pain. When large joints are involved, such as the knee, there can be loss of cartilage with limitation of motion from the joint damage. When arthritis affects the small joints in fingers, there can be bone growth and loss of hand grip and grip strength of the hand.

Many of the forms of arthritis, because they are rheumatic diseases, can cause symptoms affecting various organs of the body that do not directly involve the joints. Therefore, symptoms in some patients with certain forms of arthritis can also include fever, gland swelling (swollen lymph nodes), weight loss, fatigue, feeling unwell, and even symptoms from abnormalities of organs such as the lungs, heart, or kidneys.

 

Who is affected by arthritis?

Arthritis sufferers include men and women, children and adults.

 

How do health care professionals diagnose arthritis? Why is a diagnosis important?

The first step in the diagnosis of arthritis is a meeting between the doctor and the patient. The doctor will review the history of symptoms, examine the joints for inflammation and deformity, as well as ask questions about or examine other parts of the body for inflammation or signs of diseases that can affect other body areas. Furthermore, certain blood, urine, joint fluid, and/or X-ray tests might be ordered. The diagnosis will be based on the pattern of symptoms, the distribution of the inflamed joints, and any blood and X-ray findings. Several visits may be necessary before the doctor can be certain of the diagnosis. A doctor with special training in arthritis and related diseases is called a rheumatologist (see below).

Many forms of arthritis are more of an annoyance than serious. However, millions of people suffer daily with pain and disability from arthritis or its complications.

Earlier and accurate diagnosis can help to prevent irreversible damage and disability. Properly guided programs of exercise and rest, medications, physical therapy, and surgery options can idealize long-term outcomes for those with arthritis. Exercise and exercise routines can be helpful in providing joint stability by strengthening the musculoskeletal system while improving balance. Physical therapists can provide the care needed for properly guided exercise regimens.

It should be noted that both before and especially after the diagnosis of arthritis, communication with the treating doctor is essential for optimal health. This is important from the standpoint of the doctor, so that he/she can be aware of the vagaries of the patient's symptoms as well as their tolerance of and acceptance of treatments. It is important from the standpoint of patients, so that they can be assured that they have an understanding of the diagnosis and how the condition does and might affect them. It is also crucial for the safe use of medications.

What is the treatment for arthritis?

The treatment of arthritis is very dependent on the precise type of arthritis present. An accurate diagnosis increases the chances for successful treatment. Treatments available include physical therapy, home remedies, splinting, cold-pack application, paraffin wax dips, anti-inflammatory drugs, pain medications (ranging from acetaminophen [Tylenol] and ibuprofen [Motrin, Advil] to narcotics), immune-altering medications, biologic medications, and surgical operations. Pain from osteoarthritis of the knee can be relieved by hyaluronic acid injections. Rheumatoid arthritis can require medications that suppress the immune system. Low back arthritis that is irritating nerves of the spine can require surgical repair. For more on treatments of particular forms of arthritis, see the corresponding articles for the form of arthritis of interest.

 

What are the prognosis (outlook) for arthritis, and what are arthritis complications?

The outlook for patients with arthritis depends on its severity, complications, and whether or not there are non-joint manifestations of the disease. For example, rheumatoid arthritis can affect the lungs, kidneys, eyes, etc. Chronic joint inflammation can lead to permanent damage to the joint and loss of joint function, making movement difficult or impossible.

 

Is it possible to prevent arthritis?

Since most forms of arthritis are inherited to some degree, there is no real way to prevent them. Arthritis that follows joint injury could be prevented by adhering to safety regulations and trying to avoid becoming injured. Arthritis related to infection (for examples, septic arthritis, reactive arthritis, Whipple's disease) could be prevented by not becoming infected with the causative organism. The extent to which this is possible varies depending upon the individual condition.