ARTHRITIS

Arthritis is defined as inflammation of the joint, generally affected with pain and stiffness, redness, warmth and swelling and decreased range of motion of the affected joint.

There are many types of arthritis, most common forms of primary joint disease are:

Osteoarthritis: Also referred as degenerative joint disease – OA usually occurs with age and typically affects the weight bearing joints such as knees, hips and smaller joints of hands and feet. OA is the most common of arthritis, begins in the cartilage and eventually causes the two opposing bones to erode into each other.

Rheumatoid arthritis:Rheumatoid arthritis: Is an autoimmune disorder, commonly affects the hands and feet. The body’s immune system starts to attack own tissues of the body. RA occurs mostly in people aged 20 and above. Inflammation of the synovium and bone erosion is the central feature of RA. Bone continuously undergoes remodeling by actions of bone resorbing and bone forming cells. Investigations needed are x-ray, RA factor, CBP with ESR, CRP, anti-citrullinated protein antibody tests.

Gouty arthritis: Inflammation of joint by deposition of uric acid crystals. Initially occurs in one joint and spreads to other joints, commonly affects the great toe, ankles, knees and elbows. Investigations needed are X-ray, serum uric acid tests.

Ankylosing spondylitis: Inflammation of the joints of the spine, no known specific causative factor, but is believed to involve a combination of genetic and environmental factors. More than 90% of those affected have a specific antigen known as HLA-B27 antigen, the underlying mechanism is believed to be autoimmune or autoinflammatory. X-ray, tomography and MRI of sacroiliac joint will be helpful for early diagnosis.

Septic arthritis: Also known as Infectious arthritis, is the invasion of the joint by and infectious agent like bacteria, virus, fungus or parasites. Onset is usually rapid with more than one joint involvement and other symptoms like fever, headache and weakness etc. Common diseases where joint pain is secondary to the main disease are

Psoriatic arthritis: Most individuals develop the skin problem first and then the joint issues. Typical features are continuous pain with stiffness and swelling, recur with periods of remission

Reactive arthritis: Formerly known as Reiter’s syndrome, is a form of inflammation of the joint that develops in response to an infection in another part of the body. Reactive arthritis is an RF – seronegative, HLA-B27 linked arthritis. Manifestations of reactive arthritis are arthritis, conjunctivitis and urethritis.

Hashimoto’s thyroiditis:

SSystemic lupus erythematosus:

Diagnosis: Clinical examination and screening blood tests and x-rays. Important features of diagnosis are time of onset and progress of disease, pattern of joint involvement, symmetry of symptoms, tenderness and stiffness, locking or jelling of joint with inactivity, aggravating and ameliorating factors.