ARTHRITIS

ARTHRITIS

Although often referred to as a single disease, arthritis is actually an overall term for over 100 medical conditions that affect the musculoskeletal system (aka the joints).

 
The most common forms of arthritis are:
Osteoarthritis: a type of joint disease that results from the breakdown of joint cartilage and bone. The most common symptoms in this form of arthritis are stiffness (particularly after long periods of inactiveness), swelling, and pain. Causes of Osteoarthritis are genetics (either a defect in the body’s production of collagen which is the protein that makes up cartilage, or certain inherited traits), being overweight, injury or overuse (common in athletes or people who work in fields that require standing for long periods of time, or excessive bending and lifting), and several other factors or conditions such as Hemochromatosis (which causes the body to absorb too much Iron), or Acromegaly (which causes the body to produce too much growth hormone). Treatments for this condition include pain management (including pain medications and anti-inflammatory medications), weight management to reduce strain to the knees, hips, and ankles, physical activity to build muscle around the offending joints, stretching, physical therapy, assistive devices, natural therapies (such as herbal or nutritional supplements, acupuncture, relaxation, and hydrotherapy), and surgery.

 
Rheumatoid Arthritis: an autoimmune disease in which the body’s immune system mistakenly attacks the joints instead of foreign substances such as bacteria and viruses. The resulting inflammation causes the tissue lining the inside of the joints to thicken, causing swelling and pain. If left unchecked, the cartilage and also bone can become irreparably damaged. It is known as a ‘systematic disease’ and most commonly affects the joints of the hands, feet, wrists, elbows, knees, and ankles. The symptoms for Rheumatoid arthritis are usually: joint stiffness and swelling for over 6 weeks, more than one joint is affected, the smaller joints of the hands and wrists etc are affected, and the same joints on both sides of the body are affected. Some people also experience fatigue, loss of appetite, and a mild fever. The causes of this disease is not exactly clear but there is strong scientific evidence that suggests that genetics, hormones (70%of RA sufferers are female), and environmental factors such as bacteria or viruses triggering the development of the disease. Some studies suggest that exposure to cigarette smoke, air pollution, and insecticides can also be triggers for RA. The treatments for this form of arthritis include ‘Early, Aggressive Treatment’ which aims to reduce inflammation as early as possible, medications that either ease symptoms (Nonsteroidal anti-inflammatory drugs/NSAIDs such as ibuprofen, ketoprofen, and naproxen sodium) or medications that slow the disease activity (Corticosteroids such as: prednisone, prednisolone, and methylprednisolone, Disease-modifying Antirheumatic Drugs/DMARDs such as: methotrexate, hydroxychloroquine, sulfasalazine, leflunomide, cyclophosphamide, and azathioprine), Biologics (subsets of DMARDs that work faster), and JAK inhibitors (drugs that block the Janus Kinase pathways such as Tofacitinib), and surgery.

 
Gout: this form of arthritis occurs in people who have high levels of uric acid in their blood. This acid can form needle like crystals inside the joint which can cause severe bouts of pain when disturbed. Gout usually affects one joint at a time, but if left untreated, can affect many. The symptoms of Gout usually start with excessive pain and swelling in the big toe or other lower body joints, along with severe bouts of pain, tenderness, redness, warmth, and swelling. Causes and triggers of Gout include: joint injury, surgery or sudden illness, infection, certain diuretic medications, Cyclosporine, uric acid lowering treatment, chemotherapy, genetics, health conditions (such as high cholesterol, high blood pressure, diabetes, and heart disease), obesity, gastric bypass surgery, crash dieting, excessive ingestion of alcohol, large quantities of foods high in purines, dehydration, and excessive consumption of sugary drinks. Treatment methods include: drinking plenty of water and avoiding alcohol and sugary drinks, icing the affected joint, reduce stress, avoid certain foods high in purines and fats, losing weight, and using medications such as anti-inflammatory drugs like NSAIDs, Corticosteriods (such as prednisolone), Colchicine, and drugs that reduce uric acid levels like Allopurinol, Febuxostat, Probenecid, and Pegloticase.

 
Ankylosing Spondylitis: A form of arthritis that caused swelling and pain in joints, especially the spine. The pain and stiffness often begins in the lower back and can progress to the upper spine, chest and neck. This disease first attacks the sacroiliac joint, where the spine attaches to the pelvis, before beginning to affect other areas of the spine. Over a period of time the spinal vertebrae can fuse together causing the spine to become inflexible. Other joints commonly affected by Ankylosing Spondylitis are the hips, shoulders, and knees. It has also been known to affect certain organs like the eyes, skin, bowel, and lungs. This condition usually affects men more than women and commonly occurs between the ages of 15 – 45. Symptoms include: swelling and inflammation in the area where the spine joins the pelvis, chronic pain and stiffness in the lower back, buttocks, and hips, pain that worsens after inactivity and improves after exercise, pain in tendons and ligaments, additional pain and swelling in areas such as the neck, shoulders, and thighs, and swelling in the smaller foot and hand joints as well as ankles and knees. The main cause of this disease is thought to be genetics. Approximately 90% of people with this disease have the HLA-B27 gene. It is possible to have this gene and not have Ankylosing Spondylitis. It has also been found that smokers with AS have much more spinal damage than non-smokers. Treatments include: spinal strengthening exercises, range of motion exercises, stretching, having a good diet, quitting smoking, reducing stress, non-steroidal anti-inflammatory drugs (NSAID’s), steroids, disease-modifying anti-rheumatic drugs (DMARDs), biological disease-modifying anti-rheumatic drugs (bDMARDs which work by targeting the over produced proteins that cause inflammation and damage to bones), corticosteroids, pain relieving medication, and surgery.

 
Juvenile Arthritis: While not an actual disease in itself, JA is a blanket term to describe the inflammatory conditions or paediatric rheumatic diseases in children under 16 years of age. There are different types of JA, the main one being: Juvenile Idiopathic Arthritis which is the most common form of arthritis where the immune system attacks the body’s tissues by mistake. This illness is split into 6 subheadings: Systematic JIA (which is characterized by inflammation in one or more joints, high, spiking fever lasting over 2 weeks, skin rash, anaemia, inflammation of the heart and lungs, or enlarged lymph nodes), Oligoarticular JIA (arthritis in the larger joints, typically the elbow, knees, and ankles, along with an increased risk of chronic eye inflammation, or, Uveitis), Polyarticular JIA ( which causes inflammation in 5 or more joints, particularly those of the fingers or hands, but also weight bearing joints, and the jaw), Juvenile Psoriatic Arthritis (which involves all arthritis which occur in combination with the skin disorder psoriasis), Enthesitis-related JIA (where there is pain wherever the bone meets tendon, ligaments, or other connective tissues, usually in the areas of the hips, knees, and feet), and Undifferentiated Arthritis (which is used to describe an JA that does not fit into any of the other sub headings. There are no known caused or triggers for this disease. While there is no cure, treatments centre on minimizing inflammation, pain, and improving the child’s quality of life. These treatments include medications, exercise/physical activity, eye care, and healthy eating.

 
Systemic Lupus Erythematosus: Lupus is a chronic autoimmune disease that occurs because the immune system becomes over active and attacks the wrong tissues. Lupus affects the joints, skin, kidneys, blood, brain, and other organs. Approximately 70% of all Lupus cases are Systemic Lupus Erythematosus (SLE) which is known as the most severe form of lupus. The other forms of Lupus are: Cutaneous Lupus Erythematosus (which affects the skin), Drug-induced Lupus (which is caused by certain medications), and Neonatal Lupus (which affects the babies of women with Lupus and usually goes away after 6 months). Symptoms of Lupus include: joint pain, inflammation, a malar rash (butterfly shaped rash that goes from the cheeks across the nose), a scaly rash on the face, ears, neck, chest, or scalp, hair loss, photosensitivity, fatigue, breathing problems, kidney issues, memory problems, oral ulcers, and blood disorders such as anaemia, thrombocytopenia (low platelet count), leukopenia (low white blood cell count), and thrombosis (blood clots). The cause of Lupus is thought to be environmental factors such as stress, illness, injury, sun exposure, smoking, certain medications, and hormones, and usually occurs in people who are genetically predisposed to it. Treatments include medications, and lifestyle changes such as healthy eating and regular exercising. Medications used in the treatment of Lupus include: Nonsteroidal anti-inflammatory drugs (NSAIDs), Corticosteroids, Disease-modifying Antirheumatic drugs (DMARDs), BLyS-specific inhibitors (suppresses antibodies), and Immunosuppressive agents or chemotherapy.

 
Scleroderma: This refers to two conditions: Localized Scleroderma, and Systemic Sclerosis. Localized Scleroderma mainly affects the skin, but is also known to affect connective tissue, muscles, and bone. Linear Localized Scleroderma is characterized by streaks of thickened skin on an area of the body such as an arm or leg, while Morphea Localized Scleroderma is characterized by one or harder, oval shaped lighter or darker patches of skin. Systemic Sclerosis affects the skin, blood vessels, digestive system, muscles, joints, and other organs such as the heart, lungs, and kidneys. Limited Scleroderma affects the skin on the face, hands, and legs. It can also cause gastrointestinal and respiratory problems. Diffuse Scleroderma affects the skin, blood vessels, joints, muscles, intestines, lungs, and oesophagus as a result of the thickening of skin and tissue. Symptoms of Scleroderma include: calcium lumps, digestive problems, dryness of eyes, skin, and mouth, heart and kidney problems, respiratory problems, painful and inflamed joints, muscle weakness, skin changes, and Telangiectsasia. Causes of Scleroderma include: an overactive immune system, genetics, and environmental triggers. Steroid creams can be used to treat localized Scleroderma, as well as anti inflammatory medications, other medications used to treat the organ damage, regular exercise, and lifestyle changes such as avoiding the cold and not smoking.

 
Infectious Arthritis: This form of arthritis, also known as Septic Arthritis, is caused by an infection in the joint. This infection is often caused by bacteria, the most common being Staphylococcus Aureus. It can also be caused by viral or fungal infections. Usually, the infection enters the body elsewhere and travels through the bloodstream to the joint, resulting in intense swelling and pain. In rarer cases, this infection can be the result of direct contact with the joint due to injury or surgery. Other symptoms include other signs of infection such as fatigue, fevers, and chills. The main viruses and fungal infections that cause this disease include: Hepatitis A, B, and C, Parvovirus B19, Herpes, HIV, HTLV-1, Adenovirus, Coxsackie Viruses, Mumps, histoplasma, coccidiomyces, and blastomyces. Treatment for Infectious Arthritis is usually antibiotics for bacterial cases and antifungal medicines for the fungal cases. These are usually harder to treat. Fluid is also usually drained from the affected joint for rapid clearing of infection.

 

REFERENCES:
https://en.wikipedia.org/wiki/Osteoarthritis
http://www.arthritis.org/about-arthritis/types/osteoarthritis/causes.php
http://www.arthritis.org/about-arthritis/types/osteoarthritis/treatment.php
http://www.arthritis.org/about-arthritis/types/rheumatoid-arthritis/what-is-rheumatoid-arthritis.php
http://www.arthritis.org/about-arthritis/types/rheumatoid-arthritis/symptoms.php
http://www.arthritis.org/about-arthritis/types/rheumatoid-arthritis/causes.php
http://www.arthritis.org/about-arthritis/types/rheumatoid-arthritis/treatment.php
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/rheumatoid-arthritis
http://www.arthritisaustralia.com.au/index.php/arthritis-information.html
https://en.wikipedia.org/wiki/Arthritis
http://www.arthritis.org/about-arthritis/types/gout/what-is-gout.php
http://www.arthritis.org/about-arthritis/types/gout/symptoms.php
http://www.arthritis.org/about-arthritis/types/gout/causes.php
https://en.wikipedia.org/wiki/Arthritis#Gout
http://www.arthritis.org/about-arthritis/types/gout/treatment.php
http://www.arthritis.org/about-arthritis/types/ankylosing-spondylitis/what-is-ankylosing-spondylitis.php
http://www.arthritis.org/about-arthritis/types/ankylosing-spondylitis/articles/ankylosing-spondylitis-smoking.php
http://empowered.org.au/ankylosing-spondylitis/
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/ankylosing-spondylitis
http://www.arthritis.org/about-arthritis/types/juvenile-idiopathic-arthritis-jia/what-is-juvenile-idiopathic-arthritis.php
http://www.arthritis.org/about-arthritis/types/juvenile-arthritis/
http://www.arthritis.org/about-arthritis/types/lupus/what-is-lupus.php
https://en.wikipedia.org/wiki/Malar_rash
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/lupus
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/scleroderma
http://www.arthritis.org/about-arthritis/types/scleroderma/
http://www.webmd.com/arthritis/septic-arthritis-symptoms-diagnosis-and-treatment
http://www.arthritis.org/about-arthritis/types/infectious-arthritis/