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Overview of Arthritis
What is Arthritis:
There are over 100 types of arthritis, including osteoarthritis, rheumatoid arthritis, and gout. The word "arthritis" means "joint inflammation." Inflammation is one of the body's natural reactions to disease or injury, and includes swelling, pain, and stiffness. Inflammation that lasts for a very long time or recur, as in arthritis, can lead to tissue damage.
A joint is where two or more bones come together, such as the hip or knee. The bones of a joint are covered with a smooth, spongy material called cartilage, which cushions the bones and allows the joint to move without pain. The joint is lined by a thin film of tissue called the synovium. The synovium's lining produces a slippery fluid called synovial fluid that nourishes the joint and helps reduce friction. Strong bands of tissue, called ligaments, connect the bones and help keep the joint stable. Muscles and tendons also support the joints and enable you to move.
With arthritis, an area in or around a joint becomes inflamed, causing pain, stiffness and, sometimes, difficulty moving. Some types of arthritis also affect other parts of the body, such as the skin and internal organs.
Types of Arthritis
There are more than 100 different types of arthritis. Some of the major types include:
- Osteoarthritis:
- This is the most common type of arthritis. It occurs when the cartilage covering the end of the bones gradually wears away. Without the protection of the cartilage, the bones begin to rub against each other and the resulting friction leads to pain and swelling. Osteoarthritis can occur in any joint, but most often affects the hands and weight-bearing joints such as the knee, hip and facet joints (in the spine). Osteoarthritis often occurs as the cartilage breaks down, or degenerates, with age. For this reason, osteoarthritis is sometimes called degenerative joint disease.
- Rheumatoid arthritis:
- Rheumatoid arthritis is a long-lasting disease that can affect joints in any part of the body but most commonly the hands, wrists, and knees. With rheumatoid arthritis, the immune system -- the body's defense system against disease -- mistakenly attacks itself and causes the joint lining to swell. The inflammation then spreads to the surrounding tissues, and can eventually damage cartilage and bone. In more severe cases, rheumatoid arthritis can affect other areas of the body, such as the skin, eyes, and nerves.
- Gout:
- Gout is a painful condition that occurs when the body cannot eliminate a natural substance called uric acid. The excess uric acid forms needle-like crystals in the joints that cause swelling and severe pain. Gout most often affects the big toe, knee and wrist joints.
- Psoriatic Arthritis:
- Psoriatic arthritis (or arthropathic psoriasis) is a type of inflammatory arthritis that affects around 5-7% (according to Oxford Clinical Handbook of medicine) of people suffering from the chronic skin condition psoriasis. It occurs more commonly in patients with tissue type HLA-B27. Treatment of psoriatic arthritis is similar to that of rheumatoid arthritis. More than 80% of patients with psoriatic arthritis will have psoriatic nail lesions characterized by pitting of the nails, or more extremely, loss of the nail itself (onycholysis). Psoriatic arthritis is said to be a seronegative spondyloarthropathy.
Psoriatic arthritis can develop at any age, however on average it tends to appear about 10 years after the first signs of psoriasis.
For the majority of people this is between the ages of 30 and 50, but it can also affect children. Men and women are equally affected by this condition. In about one in seven cases the arthritis symptoms may occur before any skin involvement.
As well as causing joint inflammation, psoriatic arthritis can cause tendonitis and a sausage-like swelling of the digits known as dactilytis. Radiology will give the appearance of "fluffy, new" bone. - Degenerative Joint Disease:
- Degenerative joint disease, is a condition in which low-grade inflammation results in pain in the joints, caused by wearing of the cartilage that covers and acts as a cushion inside joints. As the bone surfaces become less well protected by cartilage, the patient experiences pain upon weight bearing, including walking and standing. Due to decreased movement because of the pain, regional muscles may atrophy, and ligaments may become more lax. OA is the most common form of arthritis.
Symptoms of Arthritis
Different types of arthritis have different symptoms and the symptoms vary in severity from person to person. Osteoarthritis does not generally cause any symptoms outside the joint. Symptoms of other types of arthritis may include fatigue, fever, a rash and the signs of joint inflammation, including:
- Pain
- Swelling
- Stiffness
- Tenderness
- Redness
- Warmth
Joint pain and progressive stiffness without noticeable swelling, chills or fever during normal activities probably indicate the gradual onset of osteoarthritis.
Painful swelling, inflammation and stiffness in the fingers, arms, legs, wrists occurring in the same joints on both sides of the body, especially on awakening, may be signs of rheumatoid arthritis.
Fever, joint inflammation, tenderness and sharp pain, sometimes accompanied by chills and associated with an injury or another illness, may indicate infectious arthritis.
A very painful, swollen, red, and warm joint may be due to gout.
In children, intermittent fever, loss of appetite, weight loss, anemia or blotchy rash on the arms and legs may signal juvenile rheumatoid arthritis.
Causes of Arthritis
There are many different types of arthritis and the cause of most types is not known. It's likely that there are many different causes. Researchers are examining the role of genetics (heredity) and lifestyle behaviors in the development of arthritis.
Although the exact cause of arthritis may not be known, there are several risk factors for arthritis. (A risk factor is a trait or behavior that increases a person's chance of developing a disease or predisposes a person to a certain condition.) Risk factors for arthritis include:
- Age: The risk of developing arthritis, especially osteoarthritis, increases with age.
- Gender: In general, arthritis occurs more frequently in women than in men.
- Obesity: Being overweight puts extra stress on weight-bearing joints, increasing wear and tear, and increasing the risk of arthritis, especially osteoarthritis.
- Work factors: Some jobs that require repetitive movements or heavy lifting can stress the joints and/or cause an injury, which can lead to arthritis, particularly osteoarthritis.
