What is Arthritis?
Arthritis is a group of conditions where there is damage caused to the bone joints of the body, resulting in inflammation. Arthritis is the leading cause of disability in the over 65’s and the disease affects about twice as many women as men.
Arthritic diseases include rheumatoid arthritis and psoriatic arthritis, which are autoimmune diseases; septic arthritis, caused by joint infection; gouty arthritis, caused by uric acid crystals; and the more common osteoarthritis, or degenerative joint disease. Arthritis can be caused from strains and injuries from repetitive motion, sports, overexertion and falls. Unlike the autoimmune diseases, osteoarthritis largely affects older people, and results from the degeneration of joint cartilage.
Arthritic joints can be sensitive to weather changes. The increased sensitivity is thought to be caused by the affected joints developing extra nerve endings in an attempt to protect the joint from further damage.
Signs and Symptoms
All arthritides feature pain, which is generally worse in the morning and on initiating movement but resolves in the course of time. In elderly people and children, the pain may not be the main feature, and the patient simply moves less (elderly) or refuses to use the affected limb (children). When faced with joint pain, a doctor generally will ask about several other medical symptoms (such as fever, skin symptoms, breathlessness, Raynaud’s phenomenon) that may narrow down the differential diagnosis to a few items, for which testing can be done. Monoarthritis (arthritis of one joint) and fever together are pointers toward septic arthritis (see below). This is a medical emergency and requires urgent referral to an orthopedic surgeon for analysis of joint aspirate and consideration for joint washout.
Diagnosis
The various types of arthritis can be distinguished by the pace of onset, the age and sex of the patient, the amount of (and which) joints affected, additional symptoms such as psoriasis, iridocyclitis, Raynaud’s phenomenon, rheumatoid nodules, and other clues. Blood tests and X-rays of the affected joints often are performed to make the diagnosis. X-rays can show erosions or bone appositions. Screening blood tests: full blood count, electrolytes, renal function, liver enzymes, calcium, phosphate, protein electrophoresis, C-reactive protein and the erythrocyte sedimentation rate (ESR). Specific tests are the rheumatoid factor, antinuclear factor (ANF), extractable nuclear antigen and specific antibodies whenever the ANF is positive.
Treatment
Treatment options vary depending on the precise condition but include surgery, drug treatment, reduction of joint stress, physical and occupational therapy, pain management, therapeutic injections with corticosteroids to control inflammation, Synvisc injections to restore joint function, or surgery. Together, you and your doctor will decide which options are right for you.
