What is Arthritis? Arthritis refers to an inflammatory disorder or condition involving one or more joints in the human body. It has more than 100 types and could also be part of a more severe disease spectrum. Usually, it presents with joint pain and stiffness with decreased range of motion of a joint.
This could be accompanied by several other features such as redness and swelling, depending on the type of arthritis. Amongst the various kinds of arthritis, the most common one is Osteoarthritis, followed by Rheumatoid Arthritis. Here is a list of a few major types:
- Rheumatoid Arthritis
- Gouty Arthritis or Gout
- Ankylosing Spondylitis
- Septic Arthritis
Arthritis could also occur as a part of other diseases, examples of which include:
- Lupus arthritis (SLE)
- Psoriatic Arthritis
- Reactive Arthritis
- Sjogren’s disease
- Sarcoidosis, etc.
Osteoarthritis is a degenerative condition and is of two types; the primary type is more common in the elderly population. It occurs due to wear and tear of the joints, with damage to the cartilage, while the synovial fluid remains clear.
Secondary Osteoarthritis is due to any previous injury to joints and can present in young ages too. Mostly, the weight-bearing joints are affected. It is characterized by morning stiffness lasting less than 30 minutes, and the pain is mild at first but increases as the day go on. The pain is usually asymmetric and is associated with swelling and inflammation.
Rheumatoid Arthritis is autoimmune and occurs due to the body’s immune system attacking the joints, causing thickening of the joint capsule and inflammation of the synovial fluid. Joints are usually symmetrically involved, characterized by severe pain, swelling, and tenderness.
The smaller joints such as those of the hands and feet are majorly involved. Morning stiffness occurs for more than 1 hour and improves with increased physical activity. Rheumatoid Arthritis has multi-organ manifestations, such as skin nodules, pulmonary fibrosis, anemia, episcleritis, autoimmune hepatitis, etc.
Gout or gouty arthritis occurs due to the increased level of uric acid in the blood, which starts depositing as uric acid crystals in the joints, tendons and even surrounding tissues. A major risk factor is increased consumption of protein and alcohol in the diet. The big toe is most commonly affected, and sudden hot flashes can occur in the joints of feet, knees, fingers, etc.
Gout has a higher prevalence rate in males, especially overweight people with low physical activity levels. It also has multi-systemic manifestations due to hyperuricemia, such as the formation of tophi and kidney stones or urate nephropathy.
Usually, arthritis is diagnosed clinically by a physician or a rheumatologist. Diagnosis depends on clinical findings, radiological investigations, and blood tests, depending on the type of arthritis suspected. X-Rays, urine analysis, blood profile are commonly performed.
For specific suspicions, the presence of the rheumatoid factor can be checked, along with anti-nuclear factor, other specific antibodies, uric acid levels for gout, etc. Joint synovial fluid aspiration can be performed to check for urate crystallization. Similarly, lupus antibodies can be checked.
Treatment includes managing and improving the symptoms first. NSAIDs are markedly used for pain relief. Physiotherapy has a major role in the improvement of stiffness and range of motion. For severe pain and inflammation, intra-articular steroid injections are also given which help reduce the swelling. Rheumatoid arthritis is treated by medications called Disease-modifying anti-rheumatic drugs (DMARDs), examples of which are Methotrexate, Sulfasalazine, Hydroxychloroquine, etc.
TNF-Alpha inhibitors such as Infliximab and Etanercept are also used for the treatment of RA. For gout, lifestyle changes such as changes in diet and increased physical activity can make a huge difference, along with medicines like Colchicine, Allopurinol, and steroids. The end stage treatment of a severely damaged joint includes joint replacement surgery or arthroplasty which is quite commonly performed these days all over the world.