Arthritis is an inflammatory disease affecting the joints, causing pain, swelling and loss of movement. It’s the second cause of disability in people over the age of 55, right after heart disease. 50 millions of Americans are affected by arthritis.
There are many forms of arthritis ( about 200 different kinds), each with its specificity. Let’s get a simple overview of the most common types of arthritis.
The most common type of arthritis is osteoarthritis, where the cartilage that protects the bones gets worn away. When the bones are exposed, their friction contribute to the formation of bony outgrowth ( like Heberden’s nodes in fingers joints). OA is a degenerative arthropathy that frequently leads to chronic pain and disability.
- 27 millions of US citizens are affected.
- Worldwide estimates are that 9.6% of men and 18.0% of women aged over 60 years have symptomatic osteoarthritis.
- Age is the most consistently identified risk factor for OA, regardless of the joint being studied. Prevalence rates rise steeply after age 50 in men and age 40 in women.
- By the age of 85, one in two persons has OA.
- There are several theories concerning the cause of cartilage deterioration. It could attacked by an enzyme found in joints fluid. Inadequate nutrition of cartilage could also result in its deterioration.
- Occupation-related repetitive injury and physical trauma contribute to the development of secondary (non-idiopathic) OA.
- Certain congenital structural defects causing misalignment (like bowlegs) can cause OA.
- Genetic factors influence the formation of Heberden’s nodes.
Severity may vary in individuals, from annoying and uncomfortable symptoms, to a significantly disabling disease.
- Painful joints on motion or weight bearing, usually alleviated by rest.
- Stiffness of affected articulations, more after inactivity or with rising air humidity.
- Joints may be creaky.
- Presence of nodes (bony outgrowth) in fingers joints.
- Loss of motion
Rheumatoid Arthritis (RA)
RA is considered a chronic, systemic disease characterized by inflammation in joints and related structures. RA is an autoimmune disorder.The immune system, designed to defend the body against aggressors (virus, bacteria, etc) is now attacking the body’s own tissues. In the case of RA, it attacks the thin membrane covering joints (the synovium) and sometimes other parts of the body. RA cannot be cured, although exacerbation alternate with periods of remission.
- Rheumatoid arthritis, affects approximately 1.5 million Americans. Between 0,3% and 1% of the world population would be affected.
- 75% of RA sufferers are woman.
- The average onset for rheumatoid arthritis is between the ages of 20 and 50 years old.
- Young children can develop a form of RA called juvenile rheumatoid arthritis.
The exact cause remains unknown. Multiple factors seem to play a role in the onset of RA:
- Autoimmunity (immune system malfunction)
- Environment (nutritional, occupational, psychosocial influences, etc )
RA often develops insidiously, starting with nonspecific complaints:
- Weight loss
- Generalized stiffness.
- Stiffness usually becomes more localized after weeks or months.
Symptoms will often involve the same articulations on both side of the body. They include:
- Inflammation (heat, swelling, tenderness)
- Stiffness (more after periods of inactivity)
- Limitation of motion
- Possible deformity in later stages
May be presents:
- Nodules (non tender masses appearing under skin)
- Neuropathy (impairment of nerves function)
- Inflammation of blood vessels (vasculitis). Can cause complications when affecting muscles, skin or other organs.
Psoriatic arthritis is related to the skin condition psoriasis. Skins changes may precede or follow articular symptoms. There are five clinical types of psoriatic arthritis, each with a different symptoms pattern.
- 10 to 15% of persons with psoriasis develops the arthritic type.
- Genetic factors appear to play an important role. There is a 50-fold increased risk of developing psoriatic arthritis in first-degree relatives of patients with the disease.
- Environmental factors have been implicated.
- Streptococcal infection can precipitate the development of guttate psoriasis.
- HIV infection can present with both psoriasis and psoriatic arthritis, as well as worsen existing disease.
- Asymmetrical arthritis is the most common presentation of psoriatic arthritis, causing pain and inflammation in 1 to 3 joints.
- Symmetrical polyarticular arthritis is much like rheumatoid arthritis, affecting joints in a symmetric pattern.
- Distal Interphalangeal (DIP) presents with fingers and toes joints involvement. Nearly always associated with nail manifestations.
- Arthritis mutilans affects less than 5% of patients and is a severe, deforming and destructive arthritis. This condition can progress over months or years causing severe joint damage.
- Axial arthritis is an inflammation of spinal column. It may presents as sacro-iliitis or spondylitis.
It is one of the most painful types of arthritis. It is characterized by recurring arthritis attacks associated with high level of uric acid. This will later cause the formation of crystals that deposits in joints, bones, cartilage, tendons, etc.
Uric acid is produced when purines are broken down by enzymes in the liver. Purines can be generated by the body itself (via the breakdown of cells in normal cellular turnover) or can be ingested in purine-rich foods (e.g. seafood, beer). Gout was once incorrectly thought to be a disease of the rich and famous, caused by consuming too much rich food and fine wine. Now, we know better that! There are 2 types of gout:
- Primary gout: A malfunction of purine metabolism leads to over production or retention of uric acid.
- Secondary gout: Where elevated uric acid is caused by another condition such as diabetes, obesity, hypertension, hyperlipidemia and others. It can also be caused by medication like chemotherapy.
- Primary gout occurs in middle-aged men 90% of the time.
- 6,1 millions of adults have ever had gout.
- Gout is a disease due to a congenital disorder of uric acid metabolism.
- Environment would also play a role.
- Gout usually attacks the big toe (approximately 75% of first attacks), however it can also affect other joints such as the ankle, heel, instep, knee, wrist, elbow, fingers, and spine.
- An acute attack of gout is a highly inflammatory arthritis often with intense swelling, redness and warmth surrounding the joint. The inflammatory component is so intense, an acute attack of gout is often mistaken for a bacterial cellulitis.
- Low fever may be present.
- An acute attack usually subsides in 7 to 10 days (treated or not).
- Chronic gout can lead to deposits of hard lumps of uric acid in and around the joints, decreased kidney function, and kidney stones.
Also known as Pyogenic arthritis. Septic arthritis is an infection, usually bacterial, in the joint cavity. Septic arthritis usually affects just one joint, though occasionally it may occur in more than one joint at a time. It is the most dangerous form of acute arthritis and requires immediate medical attention.
- More common in infant, young children and older adults.
Many different types of bacteria (germs) can cause septic arthritis.
- Infection with staph. aureus is the most common cause. Group B streptococcus and Haemophilus influenza are also causing agents.
- Chronic septic arthritis (which occurs less frequently) is caused by organisms such as Mycobacterium tuberculosis and Candida albicans.
Symptoms of of septic arthritis occur suddenly and are characterized by:
- Severe pain
- Swelling in the affected joint, with purulent effusion into the joint capsule.
- Acute pain.
- Chills and fever are also common symptoms.
We hope this article has proven useful to make you more familiar with the most common types of arthritis. Maybe you recognized some of the symptoms affecting you or one you know. It would be advisable to seek medical attention even if symptoms are mild. The first reason for that would be to obtain an exact diagnosis. Then, you can start thinking about a treatment plan and lifestyle changes. Because even though most types of arthtritis are chronic, we believe there is always something you can do to improve your condition!
Do you believe it too?
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