diease

Arthritis


Arthritis overview and Definition

Inflammation of the joints. The most common forms are osteoarthritis (degenerative joint disease) and rheumatoid arthritis. Osteoarthritis usually occurs with age and affects the fingers, knees, and hips. Rheumatoid arthritis is an autoimmune disorder that often affects the hands and feet. Other types include gout,lupus ,fibromyalgia ,septic arthritis.


Epidemiology

 It is more common among the old age group of above 65 years.I t is more common in women when compared to men.

 

 


Pathophysiology

The arthritis afffcets single joints or multiple joints.

Type sof arthritis:

1.Rheumatoid arthritis:

 It is a chronic inflammatory condition of the joints.initially the synovial memebrane becomes swollen due to the predisposing factor and losses its smoothness and it ends in thickening of the embrane.Blood flow to the site is increased and depositions of fibers and white blood cells happen giving rise to the formation of pannus(a mass formed from fibres) which reduces the gap between two joints resulting in stiffness of the joints.sometimes the joint bone is exposed.

2.Osteoarthritis:

It ocuurs mainly in cartilages.Inspite of greater number of inflammatory cells taking the reactions osteoarthritis mainly depends upon the chondrocytes(termed as cartilage producing cells).The main problem is the cartilages rejunuvate and new cells are formed but the new cells undergoes death very soon.The degeneration of the chondrocytes continues.In the end cartilages crack and small pieces come out of the fluid and thus the synovial fluid starts to flow away from the joints.Resulting in bony outgrowth and the tissue expands.

3.Juvenile idiopathic arthritis:

Chronic joint inflammation and occurs before the age of 16.itincludes:

  • Systemic-onset JIA
  • Persistent or extended oligoarthritis
  • Rheumatoid factor (RF)–positive polyarthritis
  • Rheumatoid factor (RF)-negative polyarthritis
  • Enthesitis-related arthritis
  • Psoriatic juvenile idiopathic arthritis
  • Undifferentiated arthritis

4.Seronegative spondylo arthropathies: it is immune mediated and infkammmation is caused by an unknown antigen

  • Ankylosing spondyloarthritis
  • Reactive arthritis
  • Reiter syndrome
  • Enteritis-associated arthritis
  • Psoriatic arthritis
  • Arthritis associated with inflammatory bowel disease

5.nfectious arthritis:

It is also termed as septic arthritis.micro organisms enter the joint space and infect the articular spaces.it includes,

  • Bacterial arthritis
  • Tuberculous arthritis
  • Lyme arthritis
  • Viral arthritis
  • Fungal arthritis

6.Crystal induced arthritis:

Crystals include monosodium urate as in gout,disodium phosphoglycerate as in pseudo gout,calcium phosphate .these are termed as exogenous crstals.Endogenous crystals include corticosteroid crystals,polyethylene,methylacrylate and talcum.deposition of these crystals occurs in spaces between the articular joint.

  • Gout and gouty arthritis
  • Calcium pyrophosphate crystal deposition disease (pseudo-gout)

Traumatic arthritis:

Traumatic or post-traumatic arthritis is joint inflammation due to injury. The trauma may affect the entire joint or just parts of its like the cartilage or bone. It may be caused by a fall, sporting injury like a kick, motor vehicle accident, assault, bullet or knife wound and so on.


Clinical signs & symptoms

:joint stiffness

Pain during movement of the joints

Malaise and fatigue

Weight loss

Rashes

Muscle ache and pain

Tenderness

Numbness and tingling

Reduced range of motions


Differential Diagnosis

Laboratory test:

Analysis of different types of body fluid is indicated.Fluids include blood,urine and joint fluids.

Imaging:

Xrays-bone can show damage to cartilage,bone damage and bone spurs.but xray fails to show any arthritic damage

Computerized tomography:it shows cross sectional views of internal structures.

Magnetic resonance imaging:

Cross section studies of soft tissues such as cartilage ,tendons and ligaments are obtained.

Ultrasound:

Soft tissue image,cartilage and fluid structure are obtained.

Arthroscopy:It is an 3D device used to visualize the joint images.


Prognosis

the prognosis is good on taking medications


Prevention

 

Do stretch exercises

Reduce the body weight

Eat fish or twice a week-since fish contains omega 3 fatty acids which can reduce inflammation in the bone.

Exercise regularly

Protect the joints and avoid joint injuries.

Recovery period:

It is a chronic  condition.It might takes months to years to go away.


Reference

www.healthline.com

www.nhs.uk

http://www.cdc.gov.in

davidson's principle of general medicine-22nd edition

http://www.wrthritis.com

http://clevelandclinic.com