Overview
The human body consists of different bones that have various names. Bones are connected to each other at the joints. Arthritis is a disease that affects the joints. It can affect any joint within the body.
Most commonly affected joints are;
- Hips
- Knees
- Hands and wrists
- Feet and ankles
- Shoulders
Note that several conditions have similar symptoms as arthritis. These are;
- Lupus- an Auto-immune condition
- Fibromyalgia
- Polymyalgia rheumatica(PMR)
- Back pain
- Tendinopathy
Arthritis refers to more than 10 rheumatic diseases and conditions which affect joints,
Types
Arthritis can present in one of the following forms;
- Osteoarthritis
- Rheumatoid arthritis
- Gout
- Ankylosing spondylitis
- Psoariatic arthritis
- Juvenile idiopathic arthritis
- Septic arthritis
- Reactive arthritis
Juvenile idiopathic arthritis;
Previously, it was referred to as juvenile rheumatoid arthritis- The condition affects minors under 16 years old
- It causes joint pain, swelling and stiffness. Other signs and symptoms include fever, rashes and swollen lymph nodes.
- This type of arthritis affects one or many joints.
- Sub-classifications of Juvenile RA are oligoarticular and polyarticular.
- Occurrence is due to immune system of the body attacking self cells and tissues.
- The reason why this happens is unknown, but hereditary and environmental factors play roles.
- Juvenile idiopathic arthritis leads to growth and eye problems.
Gout;
A complex form of arthritis characterized by high levels of serum uric acid. This crystallizes and deposits in one or more joints. Precipitation in joints occurs as mono-sodium urate crystals- Characteristics include attacks of pain, redness, swelling and tenderness in affected joints, especially the big toe of the foot.
Causes of rheumatoid arthritis include;
- High purine diets. For example, ingestion of red meats and organ meats such as liver, kidney, heart
- Alcoholic beverages with high fructose levels promote higher uric acid levels
Risk factors for gouty arthritis include;
- Previous or current family history of gout
- Sex- males have higher uric acid levels
- Medications such as low dose aspirin, hypertension treatment drugs which include thiazide diuretics, angiotensin-converting enzyme inhibitors and beta-blockers can lead to increases in serum uric acid levels.
Osteoarthritis;
- Osteoarthritis affects bones.
- Occurs when the protective cartilage that cushions bone ends wears down. It mostly affects the joints of the hands, knees and spine.
- It is associated with signs and symptoms such as joint pain, joint stiffness, joint tenderness, bone spurs and swelling.
- Risk factors include metabolic diseases such as haemachromatosis(too much iron in the body tissues), genetic predisposition, joint injuries, sex(women), older ages and obesity.
Signs and symptoms include;
- Inflammation and redness of the affected joints
- Limited motion range which is directly related to progression of gout
- Intense joint pain
Epidemiology & Prevalence
- Arthritis is an extremely common condition.
- It is estimated that almost 10 million people in the United Kingdom have arthritis. Osteoarthritis, the most common type, accounts for more than 50% of these cases.
- It affects individuals across all ages, inluding children and teenagers.
- In the United States, more than 58 million adults suffer from arthritis
Aetiological Factors
- Idiopathic arthritis- whose causes are unknown
- Viral infections such as COVID-19 can lead to viral arthritis
- Hyperuricaemia(too much uric acid in blood>6 mg/dL) can lead to gouty arthritis
- Joint wear and tear- Osteoarthritis
Risk Factors
- Smoking tobacco and associated products
- Family history- Individuals whose family members have arthritis are at risk of developing the same condition
- Auto-immune diseases
- Obesity
- Reduced levels of physical activity
- Age- persons older than 50 years of age
- Sex- More prevalent in women as compared to men
Signs & Symptoms
- Joint pain
- Inflamed joints
- Discoloured skin
- Joint stiffness
Diagnosis & Diagnostic Tests
- Physical examination of the joint. Observe range of motion and compare ranges between 2 similar joints
- Arthritis tests;
- Ultrasound
- Computer Tomography (CT) scan
- Magnetic Resonance Imaging (MRI) scan
- X-ray test
- Blood tests- to check for serum uric acid levels
Treatment & Management
For acute gout, administer Nice Cold Compressions(NCC) which stand for NSAIDs such as paracetamol, Colchicine and Corticosteroids( cortisone shots).
Non-Steroidal Anti-Inflammatory Drugs such as low dose aspirin are contra-indicated in gout as they precipitate the condition.
And actually, ice cold compressions work as pain relievers in acute gout.
For chronic gout, administer uricosurics such as probenecid or synthesis inhibitors such as allopurinol and febuxostat.
Disease-Modifying Anti-Rheumatic Drugs(DMARDs) for rheumatoid or psoariatic arthritis.
Surgery
Prevention
- Avoid smoking cigarettes and other tobacco products
- Exercises such as swimming, cycling and brisk walking