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Common Types of Arthritis

Ways to Manage the Joint Disease


Jan 26, 2008 Catherine Ymbong-Ancheta
Arthritis, an inflammation of the joints, has many different types with different etiology,
symptoms, treatment and management. Correct diagnosis is therefore necessary.

The basic features of arthritis are stiffness, swelling, redness and pain of the inflamed joints. This
disease usually occurs during old age; however, younger people may also be affected.
The pathogenesis of arthritis varies depending on the type. Some common types of arthritis are:
rheumatoid arthritis, osteoarthritis and gout. Other types include infectious arthritis, ankylosing
spondylitis, fibromyalgia, etc. An individual can have more than one type of arthritis
simultaneously.

Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease wherein the white blood cells attack the bodys
own cells. In this case, the cells attacked are located in the joints, which explains the redness and
warmth (accumulation of blood in the area), swelling, and pain in the joint areas. In most cases,
symmetry of infection (ex: both right and left knee joints) is observed. Other symptoms are
morning stiffness, fatigue, mild fever and weight loss.
There is no single definitive test for the diagnosis of rheumatoid arthritis. However, anemia, the
presence of rheumatoid factor (RF) and increased erythrocyte sedimentation rate in the blood
tests are consistent with this disease.
It is unknown what causes rheumatoid arthritis. It is theorized that certain changes in the immune
cells, believed to be brought about by genetic predisposition and by infection, cause them to go
haywire.
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Medications which aim to slow the progression of the disease are important, to prevent joint
damage and disability later on.
Eating fish which is high in omega-3 fatty acids, diet emphasizing fruits, vegetables and whole
grains, and antioxidant vitamins are considered helpful in preventing this type of arthritis.
Smoking should also be avoided, as it is found to increase the risk of rheumatoid arthritis.

Osteoarthritis

Osteoarthritis, from the word osteo, meaning bone, is caused by the wear and tear of the
cartilage in the joint area which leads to inflammation. The destruction of the bone can occur
when there is mechanical stress to the area. In most cases, the inflammation occurs in one part of
the body only (ex: right knee or left knee, not both); and there is joint pain during or after use of
such joint.
Osteoarthritis is diagnosed by x-ray on the affected area, which shows narrowing of joint space
and bone spurs around the joint.
It is helpful to get adequate calcium and vitamin D, for bone strengthening and development, and
exercise. Maintaining an ideal weight along with healthy diet is also recommended.
It must be noted that some medications (e.g., corticosteroids, certain anti-inflammatory drugs)
can accelerate osteoarthritis. Increased age, joint injury, overweight, and weakening of muscle
(that serves as protective shock absorber around the joint) are also risk factors for osteoarthritis.

Gout

Gout is the result of years of accumulation of uric acid in the joints, which causes the pain and
swelling. Uric acid is the product of purine metabolism, thus taking increased amounts of purine
will lead to increased accumulation of uric acid. High-purine foods include meat organs (liver,
kidney and brain), seafood (anchovies, herring, sardines, scallops, lobster) and beans. People
with gout should minimize intake of these foods as well as limit meat protein.
Presence of uric acid crystals on microscopic examination of synvoial fluid indicates gout.
Obesity, high blood pressure, high cholesterol, alcohol consumption and diabetes are also risk
factors for gout.
Correcting hyperuricemia, increasing fluid intake, diet modification, and urate-lowering drugs, if
necessary, can help treat gout.

Treatment
Treatment for arthritis pain involves the use of pain-relieving drugs and creams.
Hot and cold compress will help alleviate pain. Moist, hot compress is recommended.
Exercise, as long as it does not stress the joints, and choosing appropriate footwear are also
important.
Read more at Suite101: Common Types of Arthritis: Ways to Manage the Joint Disease
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Meaning of Arthritis:
joint inflammation (arth = joint; itis = inflammation)
One misconception about arthritis is that only one kind exists. However, arthritis refers to more
than 100 different diseases that affect the joints and tissue around the joints. Some forms, such as
rheumatoid arthritis or lupus, can affect other parts of the body. People with arthritis face many
challenges as a result of the disease, including pain, stiffness, and other symptoms. If you do
have arthritis, it is important to review the most common types and get the proper diagnosis from
a health professional.
Osteoarthritis:

What It Is: it is also known as a degenerative joint disease or a disease that worsens
with age.
o Often a result of traumatic injury to joints through athletic activities, an
automobile accident, and industrial accidents often resulting in the early
breakdown and destruction of cartilage.
o All joints are affected but the greatest amount of degeneration occurs in weightbearing joints, such as the lower spine, hips, knees, and ankles.
o Symptoms include pain and stiffness in the joints and in severe cases creaking,
popping, and grinding sounds are heard.
o Can cause disfiguring and painful destruction of the hand and shoulder joints
and can be a major source of chronic disability.
o Severe, advanced, degenerative arthritis often requires total surgical joint
replacement.

Risk Factors: Joint trauma, obesity; and repetitive joint use causing the breakdown of
cartilage and bones from the wear and tear of life.

Treatments: Medications, education, physical activity and exercise, heat or cold, joint
protection, weight loss if overweight, sometimes surgery.

Adult Rheumatoid Arthritis:

What It Is: an auto-immune disease that occurs when the bodys immune system attacks
the lubrication liquid the joints are surrounded by, leading to damage of both the cartilage
and adjacent bone.

Affects any joint but most commonly starts with inflammation in the hands and feet
while also affecting the wrists, elbows, shoulders, ankles, and knees.

Cause of disease remains unknown, although doctors suspect that genetic factors along
with environmental factors trigger the disease.

Gradually joints become tender and muscles around the joints become spastic.

Reluctance to move joints due to severe pain results in muscle wasting, and the
surrounding muscles are weakened and shrink from lack of use.

Disease lasts for up to 20 years or more with only 50 percent of those who have
struggled with the condition recovering enough to go back to their original occupations.

Ten percent never recover and are severely disabled and confined to a bed or a
wheelchair.

Possible Risk Factors: use of hair dyes for more than 20 years; using insulin
replacement therapy for diabetes; psychosocial stress related to marital problems; tickborne infections, exposure to horses, a short fertility period, smoking, and previous
injury.
o In men, the use of private well water and exposure to mold indoors were linked to
the development of rheumatoid arthritis.
o Occupational hairdressers have also been linked to rheumatoid arthritis.

Treatments: Medications, exercise, rest, and joint protection.

Juvenile Arthritis:

What It Is: it is similar to forms of arthritis that adults suffer from, often affecting five or
more joints.
o Occasionally affects other body systems, including causing anemia,
enlargement of the spleen, fever, swelling in lymph glands, and skin rash;
o Females are more likely to develop this condition than males.
o 90 percent of the time juvenile arthritis does not develop into rheumatoid arthritis.

Ankylosing Spondylitis:

What It Is: a condition affecting the sacroiliac and spinal joints causing them to become
fused, resulting in spinal stiffness and rigidity. It is often accompanied by a low-grade
fever, significant fatigue and weight-loss.
o In severe cases the spine is pulled into a forward, bent posture, making the
patient incapable of looking ahead.
o Develops in young people in their late teens but is never diagnosed in patients
until after age 30.
o Even minor spinal trauma can cause fractures.
o May affect hips, making walking very difficult and resulting in the need for hip
replacement therapy.

Gouty Arthritis:

What It Is: a painful condition that affects the joints in the feet, specifically in the region
of the great toe.
o Cause is unknown, but actual acute attacks of gout that can last up to several
weeks result from excessive alcohol use or carelessness in diet.
o Large deposits of sodium monourate crystals, known as uric acid crystals,
form in the tissues surrounding the affected joints, causing pain and over time,
and inflammation that slowly ruins cartilage; damage from uric acid inflammation
can lead to degenerative joint disease.

o Affects middle-aged men and older men, with a family history of the disease in
50 percent of the cases.

Psoriatic Arthritis:

What It Is: a condition found in two percent of people with the skin condition psoriasis
who develop this associated form of arthritis.
o Affects many joints in the body, especially those in the hands and the feet.
o Very painful and can lead to degeneration and disability in some people.

Septic or Infectious Arthritis:

What It Is: occurs when germs infiltrate a joint, through the bloodstream or through a
cut, puncture, wound or scrape. Symptoms include pain in the region of the joint, muscle
spasm, and recognized tenderness and swelling.
o Can cause joint dislocation, and joint fusion and rigidity.
o Represents a real emergency because it can spread to other areas of the body
through the bloodstream, perhaps resulting in death.
o Immediate treatment by a health professional is required to minimize
complications.

Arthritis, any of more than 100 different diseases causing pain, stiffness, and in most cases,
swelling in the joints. According to the National Arthritis Foundation, arthritis is the number one
cause of physical disability, affecting nearly 43 million Americans 16 percent of the
population of the United States. Arthritis affects people of both sexes and of all races,
socioeconomic levels, and geographic areas. Although most forms of arthritis are more common
in adults, about 300,000 children in the United States suffer from some type of arthritis-related
disease.

Joint Damage Caused by Arthritis


Joint Damage Caused by Arthritis
The term arthritis refers to more than 100 different diseases causing pain, stiffness, and
inflammation in the joints. Healthy joints are composed of cartilage and lubricating fluid,
called synovial fluid, encased in a joint capsule, or synovial membrane. In osteoarthritis,
the most common form of arthritis, joint cartilage is destroyed and, in some cases, bony
outgrowths known as bone spurs develop. In rheumatoid arthritis, white blood cells in the
synovial membrane divide, grow, and multiply, producing inflammation, pain, and stiffness
in the joint, which may eventually lead to cartilage destruction.
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Joints, found where two bones in the body meet, cushion the bones and prevent them from
rubbing against each other during movement. Joints are composed of cartilagesmooth, elastic
tissuesurrounded by a casing called the joint capsule. The joint capsule is lined with a synovial
membrane that secretes synovial fluid, a liquid that fills the joint cavity and further reduces
friction between the bones. Although all arthritic conditions involve joint pain, the severity,
duration, and effects of this pain vary considerably from one condition to another.
II.
OSTEOARTHRITIS

Osteoarthritis
Osteoarthritis
Osteoarthritis is an inflammation of the joints that results when cartilage between bones
deteriorates, causing the bones to rub together. A pair of healthy hands, left, is contrasted
with a pair of osteoarthritic hands, right.
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The most common form of arthritis is osteoarthritis (OA), also known as degenerative joint
disease. OA affects about 28 million Americans, 80 percent of whom are women. The disease is
most prevalent in people aged 55 and older. In OA, the cartilage cushion in the joints breaks
down, causing the bones to rub together. Pain, stiffness, and sometimes the formation of bone
growths, called spurs, result. OA can affect any joint, but it is most common in the hands, feet,
spine, and in large, weight-bearing joints such as the hips and knees.
Although OA is often attributed to general wear and tear associated with aging, it can also be
caused or exacerbated by a number of other problems, including obesity, injury, or repeated joint
stress. Many researchers believe that OA is in part hereditary, and may be due to genetic
abnormalities in the cells that produce cartilage.
III.
INFLAMMATORY ARTHRITIS

Inflammatory types of arthritis are characterized by their tendency to cause inflammation in


joints and tendons. In inflammatory arthritis, the synovial membrane becomes swollen and
inflamed, causing pain and stiffness. Chemicals released in the inflamed tissue increase blood
flow to the joint, causing it to look red and feel warm to the touch. To reduce pain, patients with
arthritis may favor affected joints, holding them in a fixed position. This causes the muscles
surrounding the joints to stiffen and weaken and the tendons, which attach muscles to bone or to
other muscles, to tighten. As a result, joints may contract or change shape and patients may
eventually lose mobility. Inflammatory arthritis may be caused by autoimmune diseases in which

the bodys immune system attacks its own healthy tissue. It can also be caused by crystal
deposits in the joints or by infection.
A.

Autoimmune Diseases

Rheumatoid Arthritis of the Hands


Rheumatoid Arthritis of the Hands
Rheumatoid arthritis can result in severe deformation of the hands, wrists, feet, ankles,
hips, and shoulders. The characteristic swelling, pain, and restricted movement associated
with this disease can be treated with anti-inflammatory drugs and physiotherapy.
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In autoimmune disease, a glitch in the immune system leads disease-fighting cells to attack the
bodys own healthy tissue, in this case the synovium. The causes of arthritis-related autoimmune
responses are not well understood, but scientists believe genetics may play a role. Although some
genes have been identified that predispose people to certain forms of inflammatory arthritis,
these genes are not the only factor. Researchers continue to search for other genes involved, and
for external triggers, such as viruses, bacteria, or other environmental agents, that may set off the
disease in genetically predisposed people.
One of the most common forms of arthritis due to autoimmune disease is rheumatoid arthritis
(RA). Often regarded as the most serious, painful, and disabling of all forms of arthritis, RA
affects more than 2.1 million Americans, usually between the ages of 20 and 40, and is three
times more likely to affect women than men. RA occurs most often in the same joints on both
sides of the body, such as the hands, wrists, elbows, shoulders, knees, ankles, and feet. The
immune system attacks the joints synovial tissue. The resulting inflammation can lead to
widespread and severe joint damage, which may eventually restrict a patients mobility. In severe
cases, the bone itself erodes and joints may dislocate, causing the joint to freeze in one position.
The most common form of arthritis in children, juvenile rheumatoid arthritis (JRA), affects
70,000 to 100,000 children in the United States. JRA causes pain, swelling, and stiffness. It can
be mild and disappear after several years, or in severe cases, JRA can last a lifetime.

Sacroiliac Joint
Sacroiliac Joint
Ankylosing spondylitis is a form of arthritis that is two to three times more common in
men than women. It usually starts with pain in the sacroiliac joint, a fibrous joint in the
lower back between the lumbar vertebrae and the coccyx, the bones at the lower end of the
spine. It is formed of the five fused vertebrae that compose the sacrum and parts of the two
hip bones.
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There are three forms of JRA. Systemic JRA, commonly known as Stills disease, accounts for
10 to 20 percent of all JRA cases. It first appears as a high fever and characteristic rash, followed
sometimes months later by joint pain and swelling. Stills disease may also affect childrens
internal organs, causing, for instance, swelling of the outer lining of the heart, the heart itself, or
the lungs. Although most of the problems associated with Stills disease usually subside within a
few months, the arthritis may persist into adulthood.
Polyarticular JRA starts with pain, stiffness, and swelling in five or more joints, usually the small
joints of the fingers and hands, accompanied by a low fever. Polyarticular JRA often affects the
same joints on both sides of the body. The third type of JRA, pauciarticular JRA affects four or
fewer jointsusually the large joints on only one side of the body. In most children, arthritis
disappears after several years, but joint stiffness and damage can persist into adulthood.
Another autoimmune disorder, systemic lupus erythematosus, commonly known as lupus, is an
arthritis-related condition causing fever, rash, and swelling of the joints. Lupus can have serious
complications, including inflammation of the lungs, kidneys, brain, bone marrow, and the lining
of the heart. Lupus affects about 500,000 to 1.5 million Americans and is most common in young
women aged 15 to 40. Females are nine times more likely than males to develop the disease.
Ankylosing spondylitis (AS) is due to chronic inflammation of the spine. AS often begins with
pain and stiffness in the sacroiliac joint, a joint between the lower bones in the spinal column.
Although AS is often confined to the sacroiliac joint, it may progress up the spine and into the
ribs and neck. As the disease progresses, joint inflammation around the bones of the spinal

column, or vertebrae, may cause these bones to fuse. AS may also affect the hip, knee, and
shoulder joints. The disease, which affects up to 1 million Americans, usually develops before
age 40 and is two to three times more common in men than women. The tendency to develop AS
is genetic. Tests show that 90 percent of all people with AS carry a specific gene, called the
HLA-B27 gene. Because not everyone with this gene develops the disease, researchers believe
an infectious or environmental trigger is also involved.
B.

Crystal Deposition

Gout is often characterized as an inflammatory form of arthritis. But unlike the inflammation in
RA and lupus, which is related to the immune system, joint inflammation in gout is caused by
deposits of sodium urate crystals in the joints. The crystals form from excess uric acid, a waste
product circulating in the blood. Gout initially affects a single joint, often the joint in the big toe.
If untreated, it can become chronic and affect many joints. Gout affects about two million
Americans, most often males between the ages of 40 and 50. Ten to 20 percent of patients with
gout have a family history of the disease. Excessive alcohol consumption, obesity, and high
blood pressure may also increase an individuals risk of developing gout. Gout is one of the most
treatable forms of arthritis and with proper diet and care, inflammation can be prevented entirely.
C.

Infectious Arthritis

Infectious forms of arthritis are caused by bacteria or other types of infectious agents. Lyme
disease, for example, is an inflammatory form of arthritis caused by a bacterial infection
transmitted by tick bites. As the infection spreads, it can cause vomiting, fever, neck stiffness,
and headaches. If untreated, Lyme disease may lead to chronic joint inflammation, usually in the
knees, that persists long after the other symptoms. Lyme disease and most other forms of
infectious arthritis are curable with antibiotics.
Reiters syndrome develops as a complication of infection in the bowels, genital organs, or
urinary tract. There are two forms of Reiters syndrome. The first occurs with sexually
transmitted infections, especially chlamydia, and is the most common cause of arthritis in young
men. The second form is more common in older people, and usually occurs with intestinal
bacterial infection, such as salmonella. The symptoms of Reiters syndrome are pain and
swelling in the joints and tendons, and inflammation of the eyes. Typically occurring in discrete
episodes lasting weeks to months, Reiters syndrome may disappear after one episode or it may
recur and become chronic. Most Reiters syndrome patients carry the HLA-B27 gene, the same
gene observed in 90 percent of patients with ankylosing spondylitis. As is the case with AS, the
HLA-B27 gene does not appear to cause the disease, but instead predisposes individuals to a
disease that is triggered by infection.
IV.
DIAGNOSIS AND TREATMENT

Hip Replacement
Hip Replacement
X-ray of a hip joint replacement. Plastic is often used for hip, knee, and other joint
replacement surgery, providing extra years of mobility for arthritis sufferers who would
otherwise be disabled.
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Rheumatologists, physicians who diagnose and treat arthritis and related conditions, use a variety
of diagnostic techniques. The first step is a thorough history and physical examination, during
which the doctor questions the patient about symptoms and medical history to learn about
potential exposure to infectious agents or a family history of arthritis. The patient is examined to
determine the pattern of joints affected. With this information, rheumatologists are usually able
to make a diagnosis.
Laboratory tests are used to help diagnose inflammatory arthritis. For example, a blood test
called erythrocyte sedimentation rate measures how quickly red blood cells cling together and
fall to the bottom of a test tube. When there is inflammation in the body, red blood cells sink
faster. This test lets physicians evaluate how severe the inflammation is. Rheumatologists also
test a patients blood or synovial fluid for the presence of specific antibodiesdisease-fighting
agents activated in the body by infections. The presence of rheumatoid factor antibodies, for
example, is an indication of rheumatoid arthritis, and antinuclear antibodies can be an indication
of lupus. The presence of these antibodies along with clinical symptoms help establish the
diagnosis. Physicians may also elect to test for the presence of specific genes, such as the HLAB27 gene.
There is no known cure for most forms of arthritis and related conditions. The primary goal of
treatment is to reduce joint pain and inflammation and to maximize joint mobility. To this end,
rheumatologists work closely with patients and their families to develop a treatment regimen
incorporating exercise and rest as well as pain-relieving and anti-inflammatory drugs, and in
some types of arthritis, drugs that slow the progress of the disease.

Aquatic Exercise
Aquatic Exercise
Because there is no cure for most forms of arthritis, treatment programs aim to minimize
pain and preserve joint function. Physicians perscribe pain-releiving medications and
regular low impact exercise. Aquatic exercises provide a workout without undue strain on
the joints and muscles.
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Low impact, regular exercise is very important in maintaining muscle strength and joint mobility.
One of the best forms of exercise for people with arthritis is swimming, an activity that lets
participants use muscles with minimal joint strain. Arthritis sufferers benefit from physical
therapy programs specially tailored to their age level and degree of mobility. Stretching and hot
showers before exercise and applying ice packs to muscles and joints after exercise minimize
discomfort related to exercise. Rest is another crucial element of arthritis treatment. In addition
to recommending at least eight hours of sleep a night, rheumatologists may also advise patients
to use a cane, splint, sling, or special footwear to rest or stabilize affected joints periodically
during the day.
Nonsteroidal anti-inflammatory drugs (NSAIDS), such as aspirin, naproxen, and ibuprofen, and
celecoxib decrease pain and inflammation in swollen joints. NSAIDS are not always powerful
enough to control inflammation, and rheumatologists may prescribe glucocorticoids in low
doses, to be taken by mouth or injected directly into affected joints. In potentially more severe
types of inflammatory arthritis, such as RA, doctors may prescribe disease modifying antirheumatic drugs (DMARDs). DMARDs, such as hydroxychloroquine, sulfaslazine, and
methotrexate, leflunomide, and etanercept may slow the progress of some forms of arthritis,
preventing joint destruction and damage.

Almost all drugs used to treat arthritis can have side effects and may not work for all patients
with arthritis. Researchers are investigating alternatives to traditional drug therapy and other
treatment approaches.
If joint damage is severe, patients with arthritis may need to have surgical treatment. Total hip
and total knee replacements can significantly relieve pain and improve joint function. In some
cases, surgeons replace damaged or deteriorating joints with artificial stainless steel or plastic
components in a procedure called arthroplasty.
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