Presentation
Most patients with arthritis present with symptoms of inflammation. The commonest presentation of arthritis is pain. Other symptoms include:
Other symptoms are peculiar to the type of arthritis.
Entire Body System
- Fatigue
Fatigue (tiredness). Multiple tender areas. Depression. Trouble thinking, such as confusion, memory lapses (forgetting), and trouble concentrating. [web.archive.org]
But if a child seems fatigued, lacks an appetite and is losing rather than gaining weight, it’s a sign that her problem could be juvenile arthritis. [kidsgetarthritistoo.org]
Fatigue. Red, puffy hands. Hard bumps (called rheumatoid nodules) just under the skin near the joints. Loss of appetite. What causes RA? RA is a form of arthritis and a type of autoimmune disease. [familydoctor.org]
Sneak peek at the early data When it comes to fatigue, the Arthritis Power patient score was 64.32. Compared to the U.S. average of 50, the fatigue score of the study participants is not just higher, but higher in a statistically significant way. [creakyjoints.org]
Fatigue improved, which may in turn facilitate physical activity participation. [ncbi.nlm.nih.gov]
- Severe Pain
several of them over time. [web.archive.org]
Slowly the symptoms may worsen as the joint is affected to a greater extent leading to severe pain on movements and difficulty in performing daily tasks. Symptoms may suddenly worsen. This is called a flare up. [news-medical.net]
Complications A small percentage of people with psoriatic arthritis develop arthritis mutilans — a severe, painful and disabling form of the disease. [mayoclinic.com]
However, glucosamine and the placebo both relieved arthritis pain better than taking nothing, particularly in people who have moderate to severe pain from knee osteoarthritis. Chondroitin. [mayoclinic.org]
This often leads to severe pain in the big toe. Men are more likely to develop gouty arthritis than women. Rheumatoid Arthritis Another type of arthritis is rheumatoid arthritis. [foot.com]
- Asymptomatic
Patients with orofacial symptoms reported a significantly greater prevalence of negative impact of orofacial conditions on general quality of life and within the domains of emotional and social well-being compared to asymptomatic patients. [ncbi.nlm.nih.gov]
Reassurance and orthotics maybe the only things necessary in managing asymptomatic or mildly symptomatic patients. [my.gid-vlip.lv]
Although mostly asymptomatic, of greatest concern is distinguishing these manifestations from infection and tumor. [hopkinsarthritis.org]
Importantly, cervical spine instability is most often asymptomatic. [merckmanuals.com]
Bone mineral affection in asymptomatic adult patients with celiac disease. Am. J. Gastroenterol. 89, 2130–2134 (1994). 34. Valdimarsson, T., Toss, G., Ross, I., Lofman, O. & Strom, M. Bone mineral density in coeliac disease. Scand. J. [dx.doi.org]
- Reiter Syndrome
One could also ask, “Why isn’t Reiter’s syndrome called Reiter’s syndrome anymore?” [about-reactive-arthritis.com]
But as we get to Reiter's syndrome later, we'll talk about that in more detail. [khanacademy.org]
The clinical manifestations of reactive arthritis include not only Reiter's syndrome or clinically suspected postinfectious arthritis but also undifferentiated oligoarthritis and spondylarthritis. [doi.org]
syndrome ) a predilection for the lower limb osteopaenia and then osteoporosis, uniform joint space loss, subchondral cyst formation, subluxations, marginal erosions but no bone formation symmetrical involvement of the: PIPs, MCPs, and carpal bones systemic [radiopaedia.org]
The term Reiter's syndrome is used when arthritis, urethritis and conjunctivitis occur at the same time (this is rare). [patient.info]
- Rigor
Rigorous research into the use of complementary medicines in arthritis is evolving and many of the systematic reviews used in preparation of this article are being updated every few years to incorporate new trial evidence as it becomes available. [ncbi.nlm.nih.gov]
Not recommended for arthritis patients due to physical rigor. Bikram/Hot Bikram Choudhury Taught in 100-110 degree room to expel toxins and increase mobility. Not recommended for arthritis patients due to extreme heat. [hopkinsarthritis.org]
These negative results are in agreement with the previously published findings of Moseley and colleagues. 5 That trial, which was conducted by a single surgeon at a Veterans Affairs hospital, was methodologically rigorous, since use of a sham-operation [doi.org]
PRO development: rigorous qualitative research as the crucial foundation. Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation [Internet], 19 (2010 Oct), pp. 1087-1096 [27.] R. [elsevier.es]
Cardiovascular
- Hypotension
the patient's blood pressure is initially elevated because of peripheral arterial vasoconstriction resulting from an adrenergic response to pain and ventricular dysfunction However, with right ventricular MI or severe left ventricular dysfunction, hypotension [emedicine.medscape.com]
Rituximab 1 g IV at baseline and at 2 wk ( methylprednisolone 60–125 mg IV is given with each dose of rituximab to prevent hypersensitivity reactions) When the drug is being given: Mild itching at the injection site Rashes Back pain Hypertension or hypotension [merckmanuals.com]
Ibuprofen is sometimes used for the treatment of acne because of its anti-inflammatory properties, and has been sold in Japan in topical form for adult acne.[65][66] As with other NSAIDs, ibuprofen may be useful in the treatment of severe orthostatic hypotension [en.wikipedia.org]
Musculoskeletal
- Joint Stiffness
"Arthritis" describes many different diseases that cause tenderness, pain, swelling, and joint stiffness. [spine-health.com]
Other symptoms include: Swelling Joint stiffness Redness Other symptoms are peculiar to the type of arthritis. [symptoma.com]
Yet with this cute and friendly plush arthritis, you’re bound to keep your grip on reality and your sense of humor about joint stiffness and pain. FACTS: Arthritis is a disease of the joints and one of the leading causes of disability. [giantmicrobes.com]
Frequent symptoms include fatigue and joint stiffness, especially in the morning and after prolonged periods of rest. Without appropriate treatment, chronic pain, disability, and excess mortality are unfortunate outcomes of this disease. [hopkinsarthritis.org]
It is caused when the immune system malfunctions and attacks cells, making joints stiff and painful. The common “wear and tear” condition blights mainly, but not exclusively, the elderly. [express.co.uk]
- Joint Swelling
Glucocorticoids can rapidly alleviate joint swelling and pain. [ncbi.nlm.nih.gov]
[…] cause of joint swelling is arthritis. [verywellhealth.com]
This causes swelling (inflammation), and stiffness. [medlineplus.gov]
- Back Pain
Read More Is Arthritis Causing Your Back Pain? Spinal osteoarthritis is more common than you think. Find out if this condition is causing your back pain. [arthritis-health.com]
The low back pain due to facet joint arthritis has a typical pattern: The pain is mostly — more than 80% — in the back, runs into the buttocks, and often really feels like it’s in the hip. [spine-health.com]
Everything that we do is focused on taking the pain away and keeping people active. Our remit covers all conditions which affect the joints, bones and muscles, including osteoarthritis, rheumatoid arthritis, back pain and osteoporosis. [cloudywithachanceofpain.com]
Become a friend of MSK and help represent the 7 million Australians who live with arthritis, back pain, osteoporosis and other painful musculoskeletal conditions. [msk.org.au]
- Joint Deformity
Surgery is advised to correct joint deformities and supportive treatments like physiotherapy is offered to obtain maximum movement benefit from the joint. [news-medical.net]
They are the most valuable additional test in diagnosing the severity of arthritis and noting any joint deformity associated with it. [orthoinfo.aaos.org]
RA mainly attacks the joints, usually many joints at once. RA commonly affects joints in the hands, wrists, and knees. In a joint with RA, the lining of the joint becomes inflamed, causing damage to joint tissue. [cdc.gov]
Serious joint deformity and loss of motion frequently result from acute RA. However, the disease system has been known to be active for months, or years, then abate, sometimes permanently. [apma.org]
The physical exam may show: Fluid around a joint Warm, red, tender joints Difficulty moving a joint (called "limited range of motion") Some types of arthritis may cause joint deformity. This may be a sign of severe, untreated rheumatoid arthritis. [medlineplus.gov]
- Arthralgia
(Redirected from Joint pain) Arthralgia Specialty Rheumatology Arthralgia (from Greek arthro-, joint + -algos, pain) literally means joint pain.[1][2] Specifically, arthralgia is a symptom of injury, infection, illness (in particular arthritis), or an [en.wikipedia.org]
Myalgias and arthralgias are common, but an inflammatory arthritis has not been described. [ncbi.nlm.nih.gov]
Joint torment is alluded to as arthralgia. In straightforward definition Arthritis is a typical condition that causes agony and aggravation in a joint. [omicsgroup.org]
Psychiatrical
- Anger
Children who have sadness or anger about their arthritis may need extra support. Some children with JIA may need surgery, including joint replacement. Children with only a few affected joints may have no symptoms for a long period. [medlineplus.gov]
Fear, loneliness, depression, anger and anxiety are common and, if unacknowledged, can be overwhelming and disabling. [nras.org.uk]
Urogenital
- Hematuria
CYC was used more commonly than MMF for patients with ISN/RPS class IV LN (vs. class III), those who had hematuria, and those with adherence concerns. [ncbi.nlm.nih.gov]
Neurologic
- Stroke
Oral NSAIDs can cause stomach irritation and may increase your risk of heart attack or stroke. Some NSAIDs are also available as creams or gels, which can be rubbed on joints. Counterirritants. [mayoclinic.org]
Key Findings About the National Health Survey Self-assessed health status Psychological distress Chronic conditions Arthritis and osteoporosis Asthma Cancer Diabetes mellitus High cholesterol Heart, stroke and vascular disease Hypertension and measured [abs.gov.au]
[…] in large HDL with MI and ischemic stroke. [emedicine.medscape.com]
These include: Cardiovascular disease (such as angina, heart attack and stroke ). Anaemia. Infections (joint infections and non-joint infections). 'Thinning' of the bones (osteoporosis). [patient.info]
- Headache
A 64-year-old man, with a history of Crohn's disease controlled on budesonide, presented to the emergency room in August 2017 with a week history of headache, sore throat, fever, myalgias, rash, and joint pain. [ncbi.nlm.nih.gov]
Pain-Safe Foods Pain-safe foods virtually never contribute to arthritis, headaches, or other painful conditions. [pcrm.org]
The child also may develop flulike symptoms such as headache, fever, swollen glands, fatigue, and muscular aches and pain. Then arthritis may develop weeks to months after the skin rash. [healthychildren.org]
- Abnormal Gait
This case report describes the findings of a previously healthy pediatric patient with acute onset of knee swelling and abnormal gait. [ncbi.nlm.nih.gov]
Workup
Despite the advent of better imaging techniques like CT scan and MRI, the plain radiograph remains the investigation of choice in suspected cases. This is because of its availability and cost effectiveness. The most common feature of arthritis on the plain radiograph is the loss of joint space. Other features are specific to the type of arthritis.
Laboratory studies are mainly used as an adjunct since diagnosis is mostly through clinical and radiological findings. Laboratory studies usually find their use in the rheumatoid type and are mainly used for monitoring the progression or remission of the disease [7].
Treatment
There is no definite cure for most forms of arthritis. Treatment is mainly supportive and includes:
Patient with the rheumatoid type arthritis may benefit from corticosteroid use. Selected surgical procedures have also been shown to be beneficial in the treatment of this disease condition.
Prognosis
Arthritis is generally a chronic condition with the only exception being septic arthritis. The prognosis varies for patients with the different types of arthritis. The best prognosis is with septic arthritis if treated early while the rheumatoid type carries the worst prognosis. Other factors like age, lifestyle modification, obesity, other chronic diseases like diabetes and hypertension can also greatly affect prognosis.
Etiology
Arthritis, as defined earlier is an inflammation of the joint. Therefore anything that can cause pain, swelling and loss of function in a joint can be said to be a cause of arthritis. Some of these factors that may cause or predispose to arthritis are obesity, infections, age, allergies, autoimmune diseases, diet, physical activity, and genetics [2].
Epidemiology
There are different forms of arthritis and the commonest is osteoarthritis. Arthritis in any of its forms is the leading cause of disability worldwide in individuals aged 18 years and older. The exact incidence is dependent on the type of arthritis.
The prevalence, according to age distribution is about 7.3% in individuals aged between 18 and 44, and 30.3% in individuals aged between 45 and 64. In individuals 65 years and older, the prevalence is as high as 49.7%[3]. Arthritis is generally more common in women.
Pathophysiology
To understand the pathophysiology of arthritis, we need to understand the anatomical makeup of joints. A joint is where two bones are come together. These bones are held together by ligaments. The bones are covered by cartilages which allow painless and smooth movement at the joints. There is a thin film of fluid, the synovial fluid, in the joint space and this provides nutrition for the joint and cartilage. The joint is covered by a capsule. If anything goes wrong with the components of a joint, it will lead to arthritis. Most types of arthritis involve more than one of the components. The individual pathophysiology depends on the type of arthritis.
For the most common one, osteoarthritis, there is initial cartilage damage due to some of the factors listed in etiology. The chondrocytes then attempt to repair this cartilage damage which causes an increased synthesis of proteoglycans which are responsible for the resilience of the cartilages. The increased synthesis leads to a hypertrophic repair of the cartilage which causes the visible swelling in patients with osteoarthritis. Eventually, due to a long term increase in chondrocyte metabolism, degradative enzymes associated with inflammation are released which results in a loss of proteoglycans which causes the cartilage, now increased in size, to soften and lose its elasticity leading to stiffer joints and loss of joint space.
Another common form of arthritis is rheumatoid arthritis. The exact pathway that leads to the development of this condition is unclear. An external factor, like trauma, triggers an autoimmune response that leads to synovial hypertrophy and chronic joint inflammation. There are many cellular factors involved in this process like phagocytes, fibroblasts, and inflammatory mediators amongst others that eventually lead to inflammation and excess proliferation of the synovium resulting in the destruction of cartilage and many surrounding tissues [4].
Infectious arthritis is another common form of arthritis and is also known as septic arthritis. There are three ways in which the microorganism invades the joint. It could be via the blood stream, which is the most common form of infection. It could also be through contiguous spread from infectious tissues or by direct inoculation. Because the synovial fluid has adequate bactericidal activity, this condition is more commonly seen in more susceptible individuals. This susceptibility could be as a result of previous damage due to rheumatoid arthritis or an immunosuppressive state like systemic lupus erythematosus. Previously damaged joints are especially susceptible due to neovascularization which increases the chance of infection via the blood stream. Organisms responsible for this condition are mostly bacteria like Staphylococcus aureus and Neisseria gonorrhoeae, although viruses like rubella have also been implicated. The main effect of bacteria invasion is damage to articular cartilage either due to the organism’s pathologic processes or the host’s response. As the damage progresses, pannus formation begins and eventually there is cartilage erosion at the lateral margins of affected joints. These processes can be seen very early into the course if an untreated disease [5].
Juvenile rheumatoid arthritis affects patients aged 16 years and under. It is included because, even though the exact disease causing mechanism is not clearly understood, it remains one of the common chronic disease of childhood. It is however said that there is an overlap between the pathophysiology and this condition and other autoimmune diseases of childhood.
Prevention
Many of the causes of arthritis are beyond human control and as such no clear preventive measures can be instituted. Some healthy diet and lifestyle choices could however help in preventing this condition [9].
Summary
Arthritis, by virtue of the origin of the Greek word athron (joint) and the Latin suffix -itis (inflammation), can simply be defined as an inflammation of joints. Arthritis is commonly viewed as a disease of the older age group. In industrialized countries, it has been reported to be the major cause of disability in those aged 55 years and over. However, it is important to note that there are other types of arthritis that can be seen in the younger age groups [1]. Arthritis can affect any joint in the body, from the larger hip joints to the smaller interphalangeal joints. There are numerous types of this condition.
Patient Information
Definition
Arthritis is a disease of the joints. It is mostly seen in the elderly but can also be present in children.
Cause
There is no specific cause of this disease. Many factors contribute to the development of arthritis. It however has a familial history.
Signs and symptoms
The main symptoms are pain at the joint, swelling of the joint, stiffness and inability to move the joint.
Treatment
There is no known cure for most types of arthritis. It would however be beneficial to eat healthy and have healthy lifestyle practises like regular exercise [10].
References
- Jewell FM, Watt I, Doherty M. Plain radiographic features of osteoarthritis. In: Brandt KD, Doherty M, Lohmander LS, eds. Osteoarthritis. New York, NY: Oxford University Press; 1998:217-37.
- Kraus VB, McDaniel G, Worrell TW, Feng S, Vail TP, Varju G, et al. Association of bone scintigraphic abnormalities with knee malalignment and pain. Ann Rheum Dis. Nov 2009;68(11):1673-9
- Lee P, Rooney PJ, Sturrock RD, Kennedy AC, Dick WC. The etiology and pathogenesis of osteoarthrosis: a review. Semin Arthritis Rheum. Spring 1974;3(3):189-218.
- Radin ER, Paul IL, Rose RM. Pathogenesis of primary osteoarthritis. Lancet. Jun 24 1972;1(7765):1395-6.
- Mankin HJ. The reaction of articular cartilage to injury and osteoarthritis (first of two parts). N Engl J Med. Dec 12 1974;291(24):1285-92.
- Hartmann C, De Buyser J, Henry Y, Morère-Le Paven MC, Dyer TA, Rode A. Nuclear genes control changes in the organization of the mitochondrial genome in tissue cultures derived from immature embryos of wheat. Curr Genet. May 1992;21(6):515-20.
- Zgoda M, Paczek L, Bartlomiejczyk I, Sieminska J, Chmielewski D, Górecki A. Age-related decrease in the activity of collagenase in the femoral head in patients with hip osteoarthritis. Clin Rheumatol. Feb 2007;26(2):240-1.
- de Boer TN, van Spil WE, Huisman AM, Polak AA, Bijlsma JW, Lafeber FP, et al. Serum adipokines in osteoarthritis; comparison with controls and relationship with local parameters of synovial inflammation and cartilage damage. Osteoarthritis Cartilage. Aug 2012;20(8):846-53.
- Patra D, Sandell LJ. Recent advances in biomarkers in osteoarthritis. Curr Opin Rheumatol. Sep 2011;23(5):465-70.
- Messier SP. Obesity and osteoarthritis: disease genesis and nonpharmacologic weight management. Rheum Dis Clin North Am. Aug 2008;34(3):713-29.