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Arthritic diseases include rheumatoid
arthritis and psoriatic arthritis, which are autoimmune
diseases; septic arthritis, caused by joint infection;
and the more common osteoarthritis, or degenerative
joint disease. Arthritis can be caused from strains
and injuries caused by repetitive motion, sports, overexertion,
and falls. Unlike the autoimmune diseases, osteoarthritis
largely affects older people and results from the degeneration
of joint cartilage. Other forms are discussed below.
Arthritic joints can be sensitive
to weather changes. The increased sensitivity is thought
to be caused by the affected joints developing extra
nerve endings in an attempt to protect the joint from
further damage.
Signs and symptoms
All arthritides feature pain,
which is generally worse in the morning and on initiating
movement, and resolves in the course of time. In elderly
people and children, the pain may not be the main feature,
and the patient simply moves less (elderly) or refuse
to use the affected limb (children).
When faced with joint pain, a doctor
will generally ask about several other medical symptoms
(such as fever, skin symptoms, breathlessness, Raynaud's
phenomenon) that may narrow down the differential diagnosis
to a few items, for which testing can be done.
Arthritis and fever together are
pointers towards septic arthritis (see below). This
is a medical emergency, and requires urgent referral
to a rheumatologist.
Diagnosis
The various types of arthritis
can be distinguished by the pace of onset, the age and
sex of the patient, the amount of (and which) joints
affected, additional symptoms (such as psoriasis, iridocyclitis,
Raynaud's phenomenon, and rheumatoid nodules), and other
clues.
Blood tests and X-rays of the affected
joints are often performed to make the diagnosis. X-rays
can show erosions or bone appositions.
Screening blood tests: full blood
count, electrolytes, renal function, liver enzymes,
calcium, phosphate, protein electrophoresis, C-reactive
protein and the erythrocyte sedimentation rate (ESR).
Specific tests are the rheumatoid factor, antinuclear
factor (ANF), extractable nuclear antigen and specific
antibodies whenever the ANF is found to be positive.
Treatment
Treatment options vary depending
on the precise condition, but include surgery, and drug
treatment, reduction of joint stress, physical and occupational
therapy, and pain management. There are also numerous
herbal remedies that purportedly treat arthritis, including
Harpagophytum procumbens. For specifics, see the articles
on the individual conditions listed below.
In March 2005, researchers at Harvard
Medical School and Brigham and Women's Hospital in the
USA found that a diet rich in oily fish raised the body's
production of an anti-inflammatory fat, and may thus
reduce the effects of arthritis. According to their
study published in the Journal of Experimental Medicine,
this diet worked best when combined with low aspirin
doses.
Types of arthritis
Primary forms of arthritis:
Septic arthritis
Rheumatoid arthritis
Osteoarthritis
Gout and pseudogout
Juvenile arthritis
Still's disease
Ankylosing spondylitis
Secondary to other diseases:
Systemic lupus erythematosus
(SLE)
Henoch-Schönlein purpura
Psoriatic arthritis
Reiter's syndrome
Reactive arthritis
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).
Helpful Links
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