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Revision as of 16:02, 25 January 2010

Arthritis
ICD-10 M00-M25
ICD-9 710-719
DiseasesDB 15237
eMedicine topic list
MeSH D001168

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

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Please Join in Editing This Page and Apply to be an Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [3] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.

Overview

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. The most common form of arthritis, osteoarthritis (also known as degenerative joint disease) occurs following trauma to the joint, following an infection of the joint or simply as a result of aging. Furthermore, there is emerging evidence that abnormal anatomy may contribute to early development of osteoarthritis. Other forms of arthritis are rheumatoid arthritis and psoriatic arthritis, which 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.

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.

In 1715 William Musgrave published the second edition of his most important medical work De arthritide symptomatica which concerned arthritis and its effects.[1]

Medical 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.

Extra-articular features of joint disease [2]
cutaneous nodules
cutaneous vasculitic lesions
lymphadenopathy
oedema
ocular inflammation
urethritis
tenosynovitis (tendon sheath effusions)
bursitis (swollen bursa)
diarrhea
oral and genital ulceration

Blood tests and X-rays of the affected joints often are performed to make the diagnosis. Screening blood tests are indicated if certain arthritides are suspected. These might include: rheumatoid factor, antinuclear factor (ANF), extractable nuclear antigen, and specific antibodies.

Types of arthritis

Primary forms of arthritis:

Secondary to other diseases:

Diseases that can mimic arthritis include:

Differential Diagnosis of Joint Pain

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.

In general, studies have shown that physical exercising of the affected joint can have noticeable improvement in terms of long-term pain relief. Furthermore, exercising of the arthritic joint is encouraged to maintain the health of the particular joint and the overall body of the person.[3]

Another form of non-drug treatment that does have a body of proper research to support its efficacy is marine oil, from both fish and the New Zealand green-lipped mussel (Perna canaliculus). Diets high in marine oils from cold-water fish such as salmon, mackerel, and tuna have been shown to reduce the inflammation of joint conditions such as arthritis. Massage on joints with neem oil has reported improvement in chronic and acute cases.

References

  1. ↑ Alick Cameron, ‘Musgrave, William (1655–1721)’, Oxford Dictionary of National Biography, Oxford University Press, Sept 2004
  2. ↑ Swash, M, Glynn, M.(eds). 2007. Hutchison's Clinical Methods. Edinburgh. Saunders Elsevier.
  3. ↑ 6 reasons to exercise if you have arthritis

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