Arthritis is inflammation of the joints and comprises of various disease entities. It can also be a manifestation of some systemic diseases e.g Rheumatic heart disease, Hashimoto’s thyroiditis, Systemic lupus erythematosus etc. It is a leading cause of disability.
Types of Arthritis
There are over 100 types of arthritis with varying causes and risk factors but similar manifestations. Some of these types are Osteoarthritis, Rheumatoid arthritis, Gout, Psoriatic arthritis, Septic arthritis, Ankylosing spondylitis etc.
Risk Factors of Arthitis
These differ for the different types.
Osteoarthritis: Advancing age,
Trauma or previous surgery,
Reduced levels of sex hormones (andropause and menopause),
Repetitive use (‘wear and tear’ as in jobs requiring heavy labour), etc.
Rheumatoid arthritis: Genetic factors (accounts for 50% risk),
Infectious agents such as Mycoplasma organisms, Epstein-Barr virus, Rubella virus,
Immunologic factors, etc.
Gout: Genetic factors,
Certain co-morbidities e.g Diabetes mellitus, etc.
Signs and Symptoms
The most common symptom is pain, which can vary in severity. There may be swelling, tenderness, warmth, joint stiffness (likely to occur in the morning) and/or difficulty/inability to use the affected joint. The range of movement of the joint may also reduce.
Multiple joints can be affected and in some cases e.g. Rheumatoid arthritis, the same joints on both sides of the body may be affected.
Symptoms that may be present outside the joints are fever, weakness, weight loss and muscle pain.
Management of Arthritis
After clinical assessment by a doctor, tests that should be done to confirm a diagnosis of any of the types of arthritis include
- Electrolytes especially Uric acid assay (important in the diagnosis of gout)
- X-rays of affected joints, Magnetic Resonance Imaging (MRI), Bone scans (Osteoarthritis)
- Rheumatoid factor, Anti-cyclic citrullinated peptide (anti-CCP) antibodies (Rheumatoid arthritis)
- Joint fluid analysis and culture, blood culture etc. (Septic arthritis)
Treatment varies for the different types and generally involves lifestyle modification, physical/occupational therapy, pharmacologic and non-pharmacological therapy and surgery.
Lifestyle modification includes diet control and stress reduction.
Pharmacological therapy includes use of analgesics, anti-inflammatory drugs and may also involve use of antibiotics, disease-modifying antirheumatic drugs, immunosuppressants and steroids
Non-pharmacological therapy includes weight loss, exercise and unloading in certain joints.
Surgeries that can be done are arthroscopy, synovectomy, tendon realignment, osteotomy, arthroplasty, arthrodesis etc.
Use of adaptive aids can also be instrumental foe people whose daily activities are affected by the disease.
Sources: Medscape, Healthline.com, WebMD, Wikipedia