'Arthritis' (from Greek ''arthro-'', joint + ''-itis'', inflammation; plural: arthritides) is a group of conditions where there is damage caused to the
joints of the body. Arthritis is the leading cause of disability in people over the age of 55.
There are many different forms of arthritis, each of which has a different cause.
Rheumatoid arthritis and
psoriatic arthritis are
autoimmune diseases in which the body is attacking itself.
Septic arthritis is caused by joint
infection.
Gouty arthritis is caused by deposition of
uric acid crystals in the joint that results in subsequent inflammation. Additionally, there is a less common form of gout that is caused by the formation of rhomboidal shaped crystals of calcium pyrophosphate. This form of gout is known as
pseudogout. The most common form of arthritis,
osteoarthritis is also known as degenerative joint disease and occurs following trauma to the joint, following an infection of the joint or simply as a result of aging. There is emerging evidence that abnormal anatomy may contribute to early development of osteoarthritis.
History and physical examination
All arthritides feature
pain. Patterns of pain differ among the arthritides and the location. Osteoarthritis is classically worse at night or following rest. Rheumatoid arthritis is generally worse in the morning; in the early stages, patients often do not have symptoms following their morning shower. In elderly people and children, pain may not be the main feature, and the patient simply moves less (elderly) or refuses to use the affected limb (children).
Elements of the history of the pain (onset, number of joints and which involved, duration, aggravating and relieving factors) all guide diagnosis. Physical examination typically confirms diagnosis. Radiographs are often used to follow progression or assess severity in a more quantitative manner.
Blood tests and
X-rays of the affected joints often are performed to make the diagnosis.
Screening blood tests may be indicated if certain arthritides are suspected. This may include:
rheumatoid factor,
antinuclear factor (ANF),
extractable nuclear antigen and specific antibodies.
Types of arthritis
Primary forms of arthritis:
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Osteoarthritis
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Rheumatoid arthritis
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Septic arthritis
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Gout and
pseudogout
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Juvenile idiopathic arthritis
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Still's disease
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Ankylosing spondylitis
Secondary to other diseases:
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Lupus erythematosus
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Henoch-Schönlein purpura
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Psoriatic arthritis
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Reactive arthritis
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Haemochromatosis
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Hepatitis
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Wegener's granulomatosis (and many other
vasculitis syndromes)
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Familial Mediterranean fever
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Hyperimmunoglobulinemia D with recurrent fever
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TNF receptor associated periodic syndrome
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Inflammatory Bowel Disease (Including
Crohn's Disease and
Ulcerative Colitis)
Diseases that can mimic arthritis include:
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Hypertrophic osteoarthropathy
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Multiple myeloma
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Osteoporosis
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Fifth disease
Treatment
Treatment options vary depending on the type of arthritis and include
physical and
occupational therapy, lifestyle changes (including exercise and weight control), and medications (symptomatic or targeted at the disease process causing the arthritis).
Arthroplasty (joint replacement surgery) may be required in eroding forms of arthritis.
History
While evidence of primary ankle (kaki) osteoarthritis has been discovered in dinosaurs, the first known traces of human arthritis date back as far as
4500 BC. It was noted in skeletal remains of
Native Americans found in
Tennessee and parts of what is now Olathe,
Kansas. Evidence of arthritis has been found throughout history, from
Ötzi, a
mummy (circa 3000 BC) found along the border of modern
Italy and
Austria, to the Egyptian mummies circa 2590 BC.
References
External links
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Arthritis Care (UK non-profit organisation)
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Arthritis Research Campaign (UK non-profit organisation)
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American College of Rheumatologists (US professional body) - also contains classification criteria of important forms of arthritis
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British Society for Rheumatology (UK professional body)
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Arthritis Foundation (
non-profit organisation)
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Johns Hopkins Arthritis Center (
non-profit organisation)