Arthritis

Arthritis (literary inflammation of joints) is a group of different conditions including joints damage. There are many forms of this disease and each has different cause and all feature pain.
Arthritis is one of the main cause of disability in older people (usually at the age of 55).
Nature of arthritis pain depends on many factor and the main is location. Diagnosis can be made by blood tests and X-rays of the affected joint.
Treatment depends on the arthritis type and may include physical and occupational therapy, medications and arthroplasty (joint replacement surgery) which should be performed only in cases of eroding arthritis.
The main forms of arthritis are: Osteoarthritis, Rheumatoid arthritis, Septic arthritis, Gout, Calciumpyrophosphate deposition disease, Juvenile idiopathic arthritis, Still's disease, Ankylosing spondylitis.






Osteoarthritis - (degenerative arthritis or simply OA) is the most common type of arthritis resulting in pain in the joints due to cartilage damage. Since artilage is necessary to act as cushion inside joints patients experience pain because bone surfaces become less protected. Pain usually occurs during walking and standing. Because of pain movements of joint are usually decreased which can result in muscle atrophy near the afected spot and ligaments may become more lax. This disease ususally include inflammation although many pacitents have very little or no inflammation at all.
Sympthoms include chronic pain, loss of mobility due pain and usually stiffness. This pain is like sharp ache or sensation of burning in local muscles and tendons. Also it can provoke musce spasm or contractions in the tendons. Sometimes there may be fluid in the joints which can increase pain.
It usually affects hands, feets, spine, hips and knees although it can also affect any other joint.
Treatment for this kind of arthritis consists of medication or other kind of interventions which will provide improved function of the joint and reduce the pain, although sometimes surgery may be necessary. This surgeru usually consists of fragment removal, repositioning bones or fusing bone with purpose of reducing pain and increasing stability.



Rheumatoid arthritis (RA) - is chronic inflammatory disorder causing pain, stiffness, and swelling in the joints. Unlike osteoarthritis It has nothing to do with wear and tear on the joints and also isn't connected with ages. Although science don't know real reason why people develop this disease, there is presupposition that it occurs due to genetic, environmental or hormonal factors.

It's defined as autoimmune disease where immune system mistakenly attacks tussue resulting in inflammation and damage to joints.
Symptoms of rheumatoid arthritis manifest through painful, weak, warm and swollen joints. It usually affects wrists, fingers, neck, shoulders, elbows, hips, knees, ankles, and feet. It has symmetrical affect, which means if joint of left hand is affected, it will also affect same joint on the other arm.

Due to inflammatory progress, erosion and destruction of joint surface occurs which reduce movement abilities and ususally causes deformity. Pain may be very unpleasant especially in the morning.

Although there is no cure for rheumatoid arthritis yet, many different treatments can be used for alleviating its hardness. Those treatments may include acupuncture, apple diet, nettles, exercises, rest, extrations of teeth, vitamins, insulin, magnets and electric convulsion therapy (ECT)






Joint affected by Rheumatoid Arthritis
(taken from Wikipedia).





Septic arthritis - is the most dangerous form of acute arthritis, occuring due to infection of the joint which may be bacterial, viral, mycobacterial and fungal. Usually affects knees (in about 50%) but also wrists, ankles and hips can be affected commonly. Chronic form of this disease is rare.
Septic afthritis usually occurs in people who have suffered recent injury to a joint, have joint surgery or some kind of infection in their blood where bacteria are carried by the bloodstream.
Symptoms include single swollen joint which is very painful due to any kind of movement. Affected person can be febrile and can have increased leukocyte count and sedimentation rate (although many patients don't have neither of those symptoms).
If this disease isn't diagnosed and treated quickly it can be very dangerous because infected joint can be destroyed in a very short period of time.
The most common way of treatment includes intravenous antibiotics. Also analgesia and drainage of infected joints are commonly performed.



Gout - also known as metabolic arthritis, occurs due to high level of uric acid in the body. This acid is waste product of human body and normally body exclude it by kidneys through urin. In the cases of excess it accumulates in the joints assuming the form of crystals. It causes inflammation including pain, swelling and tenderness.
In the most cases this kind of arthritis affects big toe, but it can also occur in knee, foot, ankle, hand, wrist and elbow. Also it affect man (between 30 and 50 years) more oftenly then women.
Symptoms can be described as very sudden and strong attacks of pain and tenderness, warmth, redness and swelling in the joints. First attack of Gout usually occurs at night. This attacks may occur oftenly in patients who eat to much of certain foods, have some recent surgery, drink too much alcohol, had some joint injury, have strong diets and in patients having chemotherapies.
Gout can be diagnosed by physical exam and mediacl history or by testing blood or joint fluid.
Treatments options include diet, proper medications and if those methods do not help surgery may be necessary.


Chronic gout with tophi on elbow and knee (taken from Wikipedia).



Calcium pyrophosphate deposition disease (CPPD) - oftenly known as Pseudogout or Chondrocalcinosis, occurs due to deposition of calcium pyrophosphate dihydrate (CPPD) in the joints (in the form of crystals) especially in the articular and fibrocartilage. Inflammation occur due to body's reaction to these crystals. Science don't know why body is creating these crystals but it's probably abnormality in the cartilage cells or connective tissue. The cause of this disease may also be genetic.
This condition causes pain, redness, swelling and heat in the joint (or more joints). Due to cartilage damage and rubbing bones it can cause serious damages to the joint.
Treatments inlude exercises, rest, medications, removing fluid and crystals and as the last solution surgery.
Risk of this kind of Arthritis rises with age, although many people experience presence of CPPD crystals in their twenties but not everyone will have symptoms. CPPD affects knees most oftenly, but it occurs also in ankles, elbows, wrists, hands and shoulders.
It can usually be mistaken with Gout but the difference is in cause of forming crystals which in case of Gout is uric acid, not CPPD.




Juvenile idiopathic arthritis (JIA) - also known as juvenile rheumatoid arthritis (JRA) or juvenile chronic arthritis is the most common type of persistent arthritis in children before the age of 16. It may be transient or chronic. Cause of this disease is not known yet but scientists believe that due to mistake immune system releases chemicals which cause inflammation. It attacks both sexes.
Symptoms may include lethargy and reduced physical activity alond with appetite. Also limping and flu symptoms are possible. Anyway swelling of the affected joint (or more joints) is the main symptom and oftenly affects knee, wrist, ankle and joints of hands and feet.
There are three main forms of JIA: Oligoarthritis, Polyarticular Arthritis and Systemic Arthritis.
Treatment for JIA usually consists of drug therapy and injections.



Still's disease - also known as adult-onset Still's disease (AOSD) is a form of juvenile idiopathic arthritis inluding high, spiky fevers, rash, and joint pain. Also flu like muscle pain with fatique is possible. It was named by George Frederic Still (1861-1941). Although it usually occurs in children, adults can also be attacked but not so commonly. Women are more likely to develop this form of arthritis then man.
Diagnosis of this disease my be difficult cause of many different ways of manifestation.



Ankylosing spondylitis (AS) - also known as Bechterew's disease, is long-term degenerative inflammatory type of arthritis attacking spine and sacroiliac joint. It causes fusion of the spine which can lead to condition known as "mamboo spine". AS has genetic nature.
It affects young people usually under the age of 30 including chronic pain in the lower region of the spine. It more oftenly occur in man then in women. Other symptoms may fatique and aphthae (mouth ulcers). Also very early symptoms may occur at very young age about third year of life through pain in joints, usually knees and elbows.
Diagnosis is usually made by examination of spine using X-ray and some blood tests.






Unfortunatelly there is no known cure for Ankylosing spondylitis but treatments and medications can reduce its hardness. Those treatments usually consist of exercises.
In some types of AS surgery can help, especially in the knees and hips.