arthritis

Arthritis What is Arthritis? Learn about how to manage the aches and pains.

Inflammation of a joint, usually accompanied by pain, swelling, and stiffness, and resulting from infection, trauma, degenerative changes, metabolic disturbances, or other causes. It occurs in various forms, such as bacterial arthritis, osteoarthritis, or rheumatoid arthritis.

A group of diseases affecting joints or their component tissues. Several types of arthritis are recognized, and these can be divided into groups by their clinical course and pathologic appearance. There are four basic types of arthritis: inflammatory arthritis, degenerative joint disease, nonarticular rheumatism, and miscellaneous arthritis.

Inflammatory arthritis is characterized by inflammation of tissues associated with joints. Connective tissue diseases, crystal deposition diseases, infectious arthritis, and spondyloarthropathies are examples of inflammatory arthritis. Connective tissue diseases are a group of acute and chronic diseases characterized by involvement of joints, connective tissue, serosal membranes, and small blood vessels. These diseases are divided into acquired disorders (for example, rheumatoid arthritis, systemic lupus erythematosus, scleroderma, polymyositis, vasculitis) and rare hereditary diseases (for example, Ehlers-Danlos syndrome). Rheumatoid arthritis is the most common variety of inflammatory arthritis. It occurs in younger and middle-aged persons and is characterized by noninfectious inflammation of the synovium (joint-lining membrane) frequently associated with extraarticular manifestations other than in the joints. The etiology is unknown, but genetic, immunologic, infectious, and psychologic disturbances have all been suggested. The systemic disease follows a variable but slowly progressive course, marked by spontaneous flares and remissions. There are three groups of crystal deposition disease classified according to type of crystal involvement: gout (monosodium urate), pseudogout (calcium pyrophosphate), and calcific tendonitis (hydroxyapatite). Infectious arthritis is an inflammatory joint disease caused by the invasion of the synovial joint by living microorganisms such as gonorrheal, streptococcal, and staphylococcal bacteria. Such arthritis usually results from a generalized infection but may appear following local spread or after trauma. The spondyloarthropathies are types of inflammatory arthritis characterized by involvement of the axial (central) skeleton (for example, the spine rather than the limbs). Ankylosing spondylitis and Reiter's syndrome are examples of the spondyloarthropathies. See also Connective tissue disease; Gonorrhea; Gout; Staphylococcus; Streptococcus; Uric acid.

Degenerative joint disease (osteoarthritis) is a ubiquitous joint disease characterized pathologically by deterioration of cartilage lining the joints and new bone formation beneath the cartilage. The disease is very common in older persons and is thought to be inherent in the aging process. Degenerative joint disease is marked by a progressive stiffness, loss of function, and destruction of the larger, weight-bearing joints of the body. With advancing age, the continued slow damage causes increasing disability. See also Aging.

Nonarticular rheumatism is a group of diseases, also called soft-tissue rheumatisms, that includes tendonitis, bursitis, tenosynovitis, and fibrositis. The etiology is unclear, but the disorder may relate to psychobiologic or sleep disturbances or muscular and soft-tissue abnormalities. See also Bursitis; Rheumatism.

Systemic diseases of other or unknown etiology may produce arthritis or joint destruction. There are neurologic, blood, and endocrine examples of these unusual rheumatic diseases.

Disability can often result from arthritis but can be curtailed by general health maintenance, rest, and rehabilitation. Occupational and physical therapies can be helpful. Diagnosis of the particular type of arthritis is extremely important in choosing drug therapy. Rheumatoid arthritis can be treated with nonsteroidal anti-inflammatory drugs such as aspirin. Disease-modifying antirheumatic drugs and immunosuppressive drugs are also frequently used. Osteoarthritis is treated with anti-inflammatory and analgesic drugs. Cortisone compounds are also used to treat arthritis, but the dosage and duration of treatment must be carefully monitored because of significant side effects. Surgical treatment includes arthroscopic surgery and joint replacement. See also Autoimmunity.

Inflammation of the joints. Arthritis can have a number of causes (see osteoarthritis and rheumatoid arthritis).

Any of a number of types of inflammation of a joint or joints.

For more information on arthritis, visit Britannica.com.

A term that covers a number of conditions characterized by inflammation of the joints. The most common is osteoarthritis, which results from degeneration and wearing away of articular cartilage. This may gradually progress to affect underlying bones. Osteoarthritis may result from trauma, incorrect loading of the joint, or disease. Knees and hips are the most common sites affected. Athletes who repeatedly injure their joints may accelerate the onset of arthritis. Those with arthritis should choose physical activities that put the least stress on the affected joint. Cycling and swimming are often suitable if the hip is affected, for example. Severe arthritis may preclude participation in sport. See also rheumatoid arthritis.

The inflammation of tissues in the joints (such as osteoarthritis and rheumatoid arthritis), usually resulting in pain and stiffness.

Inflammation of a joint. See also arthropathy, polyarthritis.

• bacterial a. — arises from penetrating wounds, extension from adjacent tissues or by hematogenous spread, especially umbilical infection in the newborn. More common in farm animals than dogs and cats. Some specific causes are erysipelas in pigs and sheep, Streptococcus spp. in pigs, calves and lambs, coliforms in calves, Haemophilus spp. in pigs (Glasser's disease) and lambs, Arcanobacterium spp. in lambs, and Chlamydophila pecorum in calves and lambs.
• corynebacterial a. — a nonsuppurative arthritis and bursitis of lambs caused by Corynebacterium pseudotuberculosis.
• crystal-induced a. — see gout, pseudogout.
• deforming a. — see erosive arthritis (below).
• degenerative a. — see degenerative joint disease.
• drug-induced a. — a number of antibiotics, particularly sulfonamide-trimethoprin, may cause an immune-mediated arthritis and other clinical signs, including glomerulonephritis, polymyositis and thrombocytopenia.
• enteropathic a. — arthritis of unknown etiology, but associated with bowel disease such as ulcerative colitis and regional enteritis in humans. A similar condition has been recognized in dogs.
• erosive a. — characterized by the erosion of articular cartilage and destruction of subchondral bone which is dramatically demonstrated radiographically. Generally these are the immune-mediated joint diseases and include canine rheumatoid arthritis (below), polyarthritis in Greyhounds, feline chronic progressive polyarthritis. Called also deforming arthritis.
• erysipelas a. — occurs sporadically in calves, more commonly in lambs and as a major disease in pigs. In all species it is an acute or chronic, nonsuppurative arthritis.
• fibrinous a. — the acute inflammatory stage of most infectious arthritides. The joint fluid is increased in volume and is turbid and mucinous, the fibrin appearing as a particulate deposit on the serous surface.
• idiopathic nondeforming a. — occurs in dogs and uncommonly in cats in the absence of systemic lupus erythematosus or chronic infectious systemic disease. It may involve one or several joints with fever, lameness and muscle atrophy. The disease may be chronic and cyclic with spontaneous remissions and recurrences. Presumed to be immune-mediated.
• immune-mediated a. — noninfectious joint disease involving immune mechanisms. Seen mainly in dogs and cats. See also nonerosive arthritis (below).
• infectious a. — may be caused by bacteria, mycoplasma, virus, fungus, rickettsiae, or protozoa in the joint only or as part of systemic infection.
• lymphocytic–plasmacytic a. — see lymphocytic–plasmacytic synovitis.
• mycoplasma a. — Mycoplasma hyosynoviae and M. hyorhinis cause arthritis in pigs, the former with an accompanying polyserositis.
• neonatal a. — localization from a systemic infection in the joints causing septic arthritis, often in several joints, and infection in other vulnerable organs. Neonatal susceptibility is due to availability of the umbilical vessels as a port of entry and an inadequate defense until maternal antibodies provide passive immunity. Called also navel ill, omphalitis.
• nonerosive a. — includes those without significant radiographic changes. Includes the arthritis that occurs in association with canine systemic lupus erythematosus and chronic systemic infections, enteropathic arthritis and idiopathic nondeforming arthritis.
• persistent proliferative a. — see periosteal proliferative polyarthritis.
• retroviral a. — the arthritis of goats caused by a retrovirus. The syndrome also includes encephalitis and pneumonia. Called also big-knee. See also caprine arthritis–encephalitis.
• rheumatoid a. (RA) — a chronic, autoimmune disease of dogs that causes swelling and lameness in joints, often accompanied by systemic signs of fever, malaise and lymphadenopathy. The erosive, destructive changes in joints can be demonstrated on x-rays. The disease is similar to that described in humans and the diagnosis is usually based on satisfying criteria used for humans.
• septic a. — acute arthritis due to infection of a kind likely to establish a bacteremia or septicemia.
• traumatic a. — may be caused by trauma that penetrates the joint capsule, introducing infectious agents and resulting in an infectious arthritis, or injures articular cartilage or soft tissues supporting the joint.

Arthritis
Classification and external resources
Hands affected by arthritis
ICD-10	M00.-M25.
ICD-9	710-719
DiseasesDB	15237
eMedicine	topic list
MeSH	D001168

Arthritis (from Greek arthro-, joint + -itis, inflammation; plural: arthritides) is a group of conditions involving damage to the joints of the body.

There are different forms of arthritis and each has a different cause. The most common form of arthritis, osteoarthritis (degenerative joint disease) is a result of trauma to the joint, infection of the joint, or age. Other arthritis forms are rheumatoid arthritis and psoriatic arthritis, autoimmune diseases in which the body attacks itself. Septic arthritis is caused by joint infection. Gouty arthritis is caused by deposition of uric acid crystals in the joint, causing inflammation. There is also an uncommon form of gout caused by the formation of rhomboid crystals of calcium pyrophosphate. This gout is known as pseudogout.

Contents 1 History and physical examination 2 Types of arthritis 3 Treatment 4 History 5 See also 6 References 7 External links

History and physical examination

All arthritides feature pain. Pain patterns may differ depending on the arthritides and the location. Rheumatoid arthritis is generally worse in the morning and associated with stiffness; in the early stages, patients often have no symptoms after a morning shower. In the aged and children, pain might not be the main presenting feature; the aged patient simply moves less, the infantile patient refuses to use the affected limb.

Elements of the history of the disorder guide diagnosis. Important features are speed and time of onset, pattern of joint involvement, symmetry of symptoms, early morning stiffness, tenderness, gelling or locking with inactivity, aggravating and relieving factors, and other systemic symptoms. Physical examination may confirm the diagnosis, or may indicate systemic disease. Radiographs are often used to follow progression or assess severity in a more quantitative manner.

Extra-articular features of joint disease
Cutaneous nodules
Cutaneous vasculitis lesions
Lymphadenopathy
Oedema
Ocular inflammation
Urethritis
Tenosynovitis (tendon sheath effusions)
Bursitis (swollen bursa)
Diarrhea
Orogenital ulceration

^[1]

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:

• Osteoarthritis
• Rheumatoid arthritis
• Septic arthritis
• Gout and pseudogout
• Juvenile idiopathic arthritis
• Still's disease
• Ankylosing spondylitis

Secondary to other diseases:

• Lupus erythematosus
• Sarcoidosis
• Henoch-Schönlein purpura
• Psoriatic arthritis
• Reactive arthritis
• Haemochromatosis
• Hepatitis
• Wegener's granulomatosis (and many other vasculitis syndromes)
• Lyme disease
• Familial Mediterranean fever
• Hyperimmunoglobulinemia D with recurrent fever
• TNF receptor associated periodic syndrome
• Inflammatory bowel disease (Including Crohn's Disease and Ulcerative Colitis)

Diseases that can mimic arthritis include:

• Hypertrophic osteoarthropathy
• Multiple myeloma
• Osteoporosis
• Fifth disease (parvovirus infection)

Treatment

Treatment options vary depending on the type of arthritis and include Physical therapy, lifestyle changes (including exercise and weight control), medications and dietary supplements (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.^[2]

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. In early reports, arthritis was frequently referred to as the most common ailment of prehistoric peoples.^[3] 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^{[citation needed]}.

In 1715 William Musgrave published the second edition of his most important medical work De arthritide symptomatica which concerned arthritis and its effects.^[4]

See also

• Arthritis Care (charity in the UK)
• Osteoimmunology

References

1. ^ Swash, M, Glynn, M.(eds). 2007. Hutchison's Clinical Methods. Edinburgh. Saunders Elsevier.
2. ^ [1]
3. ^ Bridges PS (1992). "Prehistoric Arthritis in the Americas". Annual Review of Anthropology 21: 67-91. doi:10.1146/annurev.an.21.100192.000435. http://arjournals.annualreviews.org/doi/abs/10.1146/annurev.an.21.100192.000435. 
4. ^ Alick Cameron, ‘Musgrave, William (1655–1721)’, Oxford Dictionary of National Biography, Oxford University Press, Sept 2004

External links

• Arthritis at the Open Directory Project

v • d • e Musculoskeletal disorders: Arthropathies (M00-M19, 711-719) Arthritis (monoarthritis/ polyarthritis) Inflammation (Neutrophilia) Infectious Septic arthritis · Tuberculosis arthritis · Reactive arthritis (indirectly) Noninfectious Seronegative spondyloarthropathy: Reactive arthritis · Psoriatic arthritis · Ankylosing spondylitis Rheumatoid arthritis: Juvenile idiopathic arthritis · Adult-onset Still's disease · Felty's syndrome Crystal arthropathy: Gout · Chondrocalcinosis Noninflammatory Osteoarthritis: Heberden's node · Bouchard's nodes Other hemorrhage (Hemarthrosis) · pain (Arthralgia) · Osteophyte · Hypermobility · villonodular synovitis (Pigmented villonodular synovitis) see also congenital

v • d • e Inflammation Acute Plasma derived mediators Bradykinin · complement (C3, C5a, MAC) · coagulation (Factor XII, Plasmin, Thrombin) Cell derived mediators preformed: Lysosome granules · vasoactive amines (Histamine, Serotonin) synthesized on demand: cytokines (IFN-γ, IL-8, TNF-α, IL-1) · eicosanoids (Leukotriene B4, Prostaglandins) · Nitric oxide · Kinins Chronic Macrophage · Epithelioid cell · Giant cell · Granuloma Processes Traditional: Rubor · Calor · Tumor · Dolor (pain) · Functio laesa Modern: Acute-phase reaction/Fever · Vasodilation · Increased vascular permeability · Exudate · Leukocyte extravasation · Chemotaxis Specific types Nervous CNS (Encephalitis, Myelitis) · Meningitis (Arachnoiditis) · PNS (Neuritis) · eye (Dacryoadenitis, Scleritis, Keratitis, Choroiditis, Retinitis, Chorioretinitis, Blepharitis, Conjunctivitis, Iritis, Uveitis) · ear (Otitis, Labyrinthitis, Mastoiditis) Cardiovascular Carditis (Endocarditis, Myocarditis, Pericarditis) · Vasculitis (Arteritis, Phlebitis, Capillaritis) Respiratory upper (Sinusitis, Rhinitis, Pharyngitis, Laryngitis) · lower (Tracheitis, Bronchitis, Bronchiolitis, Pneumonitis, Pleuritis) · Mediastinitis Digestive mouth (Stomatitis, Gingivitis, Gingivostomatitis, Glossitis, Tonsillitis, Sialadenitis/Parotitis, Cheilitis, Pulpitis, Gnathitis) · tract (Esophagitis, Gastritis, Gastroenteritis, Enteritis, Colitis, Enterocolitis, Duodenitis, Ileitis, Caecitis, Appendicitis, Proctitis) · accessory (Hepatitis, Cholangitis, Cholecystitis, Pancreatitis) · Peritonitis Integumentary Dermatitis (Folliculitis) · Hidradenitis Musculoskeletal Arthritis · Dermatomyositis · soft tissue (Myositis, Synovitis/Tenosynovitis, Bursitis, Enthesitis, Fasciitis, Capsulitis, Epicondylitis, Tendinitis, Panniculitis) Osteochondritis: Osteitis (Spondylitis, Periostitis) · Chondritis Urinary Nephritis (Glomerulonephritis, Pyelonephritis) · Ureteritis · Cystitis · Urethritis Reproductive female: Oophoritis · Salpingitis · Endometritis · Parametritis · Cervicitis · Vaginitis · Vulvitis · Mastitis male: Orchitis · Epididymitis · Prostatitis · Balanitis · Balanoposthitis pregnancy/newborn: Chorioamnionitis · Omphalitis Endocrine Insulitis · Hypophysitis · Thyroiditis · Parathyroiditis · Adrenalitis

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Dansk (Danish)
n. - artritis, ledbetændelse

Nederlands (Dutch)
artritis, gewrichtsontsteking

Français (French)
n. - arthrite

Deutsch (German)
n. - Arthritis, Gicht

Ελληνική (Greek)
n. - (παθολ.) αρθρίτιδα

Italiano (Italian)
artrite

Português (Portuguese)
n. - artrite (f) (Med.)

Русский (Russian)
артрит

Español (Spanish)
n. - artritis

Svenska (Swedish)
n. - ledinflammation

中文（简体）(Chinese (Simplified))
关节炎

中文（繁體）(Chinese (Traditional))
n. - 關節炎

한국어 (Korean)
n. - 관절염

日本語 (Japanese)
n. - 関節炎

العربيه (Arabic)
‏(الاسم) التهاب المفاصل‏

עברית (Hebrew)
n. - ‮דלקת (מ)פרקים‬

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