arthritis

There are many forms of arthritis, each of which has a different cause. Rheumatoid arthritis and psoriatic arthritis 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 and subsequent inflammation. The most common form of arthritis, osteoarthritis is also known as degenerative joint disease and occurs following trauma to the joint, following an infection of the joint or simply as a result of aging. There is emerging evidence that abnormal anatomy may contribute to early development of osteoarthritis.

History and physical examination

All arthritides feature pain. Patterns of pain differ among the arthridities and the location. Osteoarthritis is classically worse at night or following rest. Rheumatoid arthritis is generally worse in the morning and 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 quantitiative 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 arthridities are suspected. This may 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 arthritis
• Still's disease
• Ankylosing spondylitis

Secondary to other diseases:

• Systemic lupus erythematosus (SLE)
• Henoch-Schönlein purpura
• Psoriatic arthritis
• Reactive arthritis (Reiter's syndrome)
• Hemochromatosis
• Hepatitis
• Wegener's granulomatosis (and many other vasculitis syndromes)
• Familial Mediterranean fever (FMF), HIDS (hyperimmunoglobulinemia D and periodic fever syndrome) and TRAPS (TNF-alpha receptor associated periodic fever syndrome).

Diseases that can mimic arthritis include:

• Pierre Marie-Bamberger syndrome (hypertrophic pulmonary osteoarthropathy, a paraneoplastic phenomenon of lung cancer)
• multiple myeloma
• osteoporosis

Treatment

Treatment options vary depending on the type of arthritis and include physical and occupational therapy, medications (symptomatic or targeted at the disease process causing the arthritis), and as a last resort, arthroplasty. Although prosthetic joint replacement is a treatment of last resort, it is generally very effective and more than 90% of patients are very satisfied.

History

While evidence of primary ankle 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. Around 500 BC willow bark gained popularity when it was discovered to help relieve some of the aches and pains of arthritis. It wasn't until more than 2,000 years later, in the early 1820s, that European scientists began to scientifically study the chemical compound in willow bark that alleviated the arthritis symptoms. They discovered the compound was salicin. When they isolated salicin, however, they found it was very noxious to the stomach. Almost 80 years later, in 1897, an employee of Bayer Company -- then a dye production company -- named Felix Hoffman discovered how to isolate the compound and make it less irritating to the stomach. Hoffman was attempting to make the drug in order to help his father, who was suffering from arthritis. In 1899, Bayer Company trademarked Hoffman's discovery under the name "Aspirin." Today it is believed that over a trillion tablets of aspirin have been sold worldwide.^[1]

References

External links

• Arthritis Foundation (non-profit organisation)
• American College of Rheumatologists (US professional body) - also contains classification criteria of important forms of arthritis
• British Society for Rheumatology (UK professional body)
• Arthritis Research Campaign (UK non-profit organisation) - funds research into all forms of arthritis and provides extensive information for patients and medical professionals