ARTHRITIS

DEFINITION
• Arthritis: inflammation of joint characterized
by pain swelling and limitation of joint
movement is called arthritis:
• Claasification:
-monoarthritis-septic arthritis, tubercular
arthritis,gout, osteoarthritis
-polyarthritis- rheumatoid arthritis,rheumatic
fever, seronegative artritis
 INCIDENCE
• Rheumatoid arthritis:female>male, 20-40 yrs
common, genetic predisposition
• Osteoarthritis: common elderly age,
male=female
• DIAGNOSIS= clinical features + radiological
findings
 CLINICAL FEATURES
OSTEOARTHRITIS: gradual onset of joint stiffness,
deep aching pain swelling of joint, feeling of locking
of joint, tenderness in joint, crepitus, joint
deformity, restriction of movement of joint,joint
effusion and swelling, wasting of muscles
RHEUMATOID ARTHRITIS: clinical features

symmetrical joint swelling with associated stiffness,tenderness and

pain usually involving metacarpophalangeal joints,
proximalinterphalageal joint,wrist, elbows

SIGNS: ulnar deviation of hand, boutonnier deformity, swan neck

deformity, rheumatoid nodules

Systemic features: general:fever ,fatigue

Muculoskeletal:bursitis,osteoporosis
Haematological:anaemia,
Lympahatic;spleenomegaly
Ocular:episcleritis,sleritis
Cardiac:pericarditis, myocarditis, endocarditis
Pulmonary:pleural effusion
Neurological:peripheral neuropathy
 INVESTIGATIONS
• RHHEUMATOID ARTHRITIS:
• Complete blood count:HB TC DC
• Raised ESR, rheumatoid factor-positive
• Synovial fluid analysis
• Synovial biopsy

X RAY of involved joint in rheumatoid arthritis=

-reduced joint spaces
-Erosion of articular margins
-Subchondral cysts
-Juxta articular rarefaction
-Soft tissue shadow due to effusion
• INVESTIGATIONS OF OSTEOARTHRITIS
-complete blood count: Hb, TC ,DC, raised ESR
-Raised CRP
Radiological features- narrowing joint spaces
-subchondral sclerosis
-subchondral cyst
-Osteophytes seen
-deformity of joint
 TREATMENT
• RHEUMATOID ARTHRITIS-rest
Drugs:NSAIDS,steroids(prednisolone),methotexrate
, sulphasalazine
-Intra articular injection of hydrocortisone
-Arthroscopic synnovectomy
-physiotherapy
• OESTEOARTHRITIS-life style modification
• Physiotherapy
• Drugs=NSAIDS, intra articular injection of
hydrocortisone,
• Arthroscopic debridement
• Total knee arthroplasty
 DIFFERENCE
RHUMATIC ARTHRITIS RHEUMATOID ARTHRITIS

-immune reaction to streptococcus -Immune system disorder

-large joints --small joints

-5-15 years --after 20 years

-migrating --constantly same joint

High grade fever --low grade fever

-rheumatic heart disease --joint stiffness

Aspirin and penicillin effective --no use of aspirin and penicillin

 QUESTIONS
• Treatment of case of rheumatic arthritis
• Write down clinical features, and management
of rheumatoid arthritis.