|
|
| Line 1: |
Line 1: |
| __NOTOC__ | | __NOTOC__ |
|
| |
| '''For the WikiDoc page for this topic, click [[Arthritis|here]]''' | | '''For the WikiDoc page for this topic, click [[Arthritis|here]]''' |
|
| |
|
| {{Arthritis (patient information)}} | | {{Arthritis (patient information)}} |
|
| |
|
| {{CMG}}; {{AE}} | | {{CMG}}; {{AE}} Jinhui Wu, M.D.; [[User:Ujjwal Rastogi|Ujjwal Rastogi, MBBS]] [mailto:urastogi@perfuse.org]; Ethan Leeman |
|
| |
|
| ==Overview== | | ==Overview== |
| [[Reactive arthritis]] is a general term for a form of [[joint]] [[inflammation]] ([[arthritis]]) that develops as a "reaction" to an [[infection]] in another area of the body (i.e., outside of the [[joints]]). [[Joint]] [[inflammation]] is characterized by redness, swelling, pain and warmth in and around the affected [[joint]]. In [[reactive arthritis]], the large [[joints]] of the [[lower limbs]] and the [[Sacroiliac joint|sacroiliac joints]] are most often affected. Two other common [[symptoms]] of reactive arthritis are [[inflammation]] of the [[urinary tract]] and [[inflammation]] of the [[membrane]] ([[conjunctiva]]) that lines the [[eyelids]] ([[conjunctivitis]]). These three characteristic [[symptoms]] may occur separately, all at once or not at all. Additional [[symptoms]] such as [[fever]], [[weight loss]], [[Low back pain|lower back pain]] and heel pain may also occur. [[Reactive arthritis]] usually develops following a bout with certain bacterial infections including Chlamydia, Salmonella, Shigella, Yersinia, and Campylobacter.
| | '''Arthritis''' and other rheumatic conditions are more than 100 rheumatic diseases and conditions that affect joints, the tissues which surround joints and other connective tissue. The pattern, severity, and location of symptoms can vary depending on the specific form of the disease. Typically, rheumatic conditions are characterized by pain and stiffness in and around one or more joints. The symptoms can develop gradually or suddenly. Certain rheumatic conditions can also involve the immune system and various internal organs of the body. |
| | |
| Reactive arthritis belongs to a group of related disorders known as the spondyloarthritidies. These disorders are linked by the association of similar symptoms and a specific genetic marker called ''HLA-B27''. Symptoms common to these disorders include arthritis, especially of the lower limbs, lower back pain and enthesitis, a condition characterized by inflammation at the spot where tendons attach to bone. This group of disorders includes reactive arthritis, ankylosing spondylitis, psoriatic arthritis, undifferentiated spondyloarthritis and spondyloarthritis associated with inflammatory bowel disease.
| |
| | |
| Reactive arthritis is a poorly defined disorder that has been described in the medical literature under many different names. No precise diagnostic or classification criteria have been developed that are universally agreed upon in the medical community.
| |
| | |
| == Signs & Symptoms ==
| |
| The specific symptoms and their severity can vary greatly from one person to another. Some individuals with reactive arthritis may only develop mild arthritis without eye or urinary tract involvement. Other individuals may develop a severe case of reactive arthritis that can dramatically limit daily activity. Symptoms usually last anywhere from 3 to 12 months and may come and go. In approximately 30-50 percent of patients, symptoms may return later or become a chronic (greater than 6 month) long-term problem. It is important to note that affected individuals may not have all of the symptoms discussed below. Affected individuals should talk to their physician and medical team about their specific case, associated symptoms and overall prognosis.
| |
| | |
| The symptoms of reactive arthritis may come and go over a period of time ranging from several weeks to several months. Symptoms usually develop one to six weeks after a gastrointestinal or genitourinary infection. Inflammation of the joints, urinary tract and eyes are the most common findings. Additional symptoms may also develop. | |
| | |
| Arthritis can occur before or at the same time as eye and urinary symptoms or after they have subsided. Arthritis usually affects the joints of the lower legs causing pain, redness and swelling in the knees, ankles and feet. Other joints such as the wrists, elbows, and fingers are affected less frequently. Onset is usually rapid with two to four joints becoming involved within a few days. Heel pain is also common. Heel pain is caused by enthesitis, a condition characterized by inflammation at the spot where the tendon attaches to bone. In some cases, the toes and/or fingers may become inflamed and swollen (dactylitis) so that they appear large and stubby. Pain in the lower back or buttocks may also occur.
| |
| | |
| Urinary tract involvement in reactive arthritis may not cause any symptoms (asymptomatic). In other cases, urinary tract inflammation may be the first symptom to develop, especially in men. Urinary tract symptoms are often absent in women. In some men, urinary tract inflammation can cause pain or a burning sensation when urinating, increased frequency of urination, or fluid discharge when urinating. In severe cases, inflammation of the prostate gland (prostatitis) may occur. In spite of these symptoms, the urine culture will typically be negative.
| |
|
| |
|
| Women with urinary tract inflammation due to reactive arthritis may develop inflammation of the cervix, inflammation of the fallopian tubes (salpingitis), or inflammation of the vulva and vagina (vulvovaginitis). Some affected women may experience a burning sensation when urinating.
| | The most common form of arthritis in the Unites States is osteoarthritis followed by gout, fibromyalgia, and rheumatoid arthritis. Currently, an estimated 46 million Americans reported that their doctor told them they had arthritis, and is expected to increase. |
|
| |
|
| Some affected individuals develop inflammation of the membrane (conjunctiva) lining the eyelids (conjunctivitis). Some people may also develop inflammation of the anterior uvea (uveitis), the part of the eye that consists of the iris, choroid and the ciliary body. Conjunctivitis and uveitis may cause redness and swelling of the eyes, eye pain, blurred vision, an abnormal sensitivity to light (photophobia) and crusting in the morning. Blurred vision and photophobia are more common with uveitis. Eye symptoms may occur early in the course of reactive arthritis. In some cases, symptoms may come and go during the duration of the disease (wax and wane).
| | ==What are the symptoms of Arthritis?== |
| | The pattern and location of symptoms can vary depending on the type of arthritis. Generally, people with arthritis feel pain and stiffness in and around one or more joints. The onset of arthritis symptoms can develop gradually or suddenly. Arthritis is most often a chronic disease, so symptoms may come and go, or persist over time. |
|
| |
|
| General, vague symptoms that can be associated with many different diseases may also occur in individuals with reactive arthritis. Such symptoms including fatigue, fever, unintended weight loss, and a general feeling of poor health (malaise).
| | ==What causes Arthritis?== |
| | Arthritis involves the breakdown of cartilage. Cartilage normally protects a joint, allowing it to move smoothly. Cartilage also absorbs shock when pressure is placed on the joint, such as when you walk. Without the normal amount of cartilage, the bones rub together, causing pain, swelling (inflammation), and stiffness. |
|
| |
|
| Additional symptoms may potentially affect individuals with reactive arthritis. In some men, small, shallow, painless ulcers may form on the penis; this is referred to as circinate balanitis. These ulcers may precede the development of arthritis. Occasionally these ulcers can form a plaque-like lesion and become chronic. In addition, some individuals may develop small, superficial ulcers in the mouth, especially the tongue or hard palate. These lesions may come and go, are usually painless and often go unnoticed. Acute diarrhea may occur in cases that develop after infection with Shigella, Yersinia, Campylobacter or Salmonella. Diarrhea may precede the development of musculoskeletal symptoms by up to one month.
| | Joint inflammation may result from: |
|
| |
|
| Some individuals with reactive arthritis develop a skin condition called keratoderma blennorrhagia. This skin lesion usually affects the palms or soles and may consist of reddish, raised, waxy bumps or nodules. These bumps usually spread, eventually coming together (coalescing) to form one larger, scaly rash that may resemble psoriasis. The nails of some individuals with reactive arthritis may become thickened.
| | *An autoimmune disease (the body's immune system mistakenly attacks healthy tissue) |
| | *Broken bone |
| | *General "wear and tear" on joints |
| | *Infection, usually by the bacteria or virus |
|
| |
|
| == Causes ==
| | Usually the joint inflammation goes away after the cause goes away or is treated. Sometimes it does not. When this happens, you have chronic arthritis. Arthritis may occur in men or women. [[Osteoarthritis]] is the most common type. See: Osteoarthritis |
| Reactive arthritis develops because of an infection that occurs in another part of the body. Even mild infections, which may go unnoticed, can cause reactive arthritis. This may be particularly true with chlamydial infections, which appear to be a rather frequent cause of reactive arthritis. The lack of a symptomatic, preceding infection in some cases obscures the diagnosis. The five bacterial infections most commonly associated with reactive arthritis are Chlamydia, Salmonella, Shigella, Yersinia, and Campylobacter. These bacteria usually cause gastrointestinal or genitourinary infections. Chlamydia is the most common cause of reactive arthritis in the United States and is usually acquired through sexual contact. Salmonella, Shigella, Yersinia, and Campylobacter may cause a gastrointestinal infection that can trigger reactive arthritis. Salmonella, Shigella, Yersinia, and Campylobacter are often acquired after eating contaminated food, handling improperly prepared food or coming into contact with the feces of a contaminated person. Less often, several other bacteria have been implicated as causative agents in reactive arthritis. However, some researchers reserve the term reactive arthritis only for those cases caused by the five abovementioned bacteria.
| |
|
| |
|
| The exact underlying mechanisms that cause reactive arthritis are not fully understood. Researchers believe that reactive arthritis is an autoimmune disorder. An autoimmune disorder occurs when the body’s immune system mistakenly attacks healthy tissue. In reactive arthritis, a preceding infection induces an immune system response. Studies have demonstrated that the bacteria, or bacterial products, travel from the initial site of infection through the blood to the tissue lining the joints (synovial tissue). In the case of chlamydiae, these synovial-based organisms are viable, albeit in an aberrant state. The significance of these synovial-based organisms or bacterial products is not completely understood.
| | Other, more common types of arthritis include: |
| | * [[Ankylosing spondylitis (patient information)|Ankylosing spondylitis]] |
| | * [[Gonococcal arthritis (patient information)|Gonococcal arthritis]] |
| | * [[Gout (patient information)|Gout]] |
| | * Juvenile rheumatoid arthritis (in children) |
| | * Other bacterial infections (nongonococcal bacterial arthritis) |
| | * [[Psoriatic arthritis (patient information)|Psoriatic arthritis]] |
| | * [[Reactive arthritis]] (Reiter syndrome) |
| | * [[Rheumatoid arthritis (patient information)|Rheumatoid arthritis]](in adults) |
| | * [[Scleroderma (patient information)|Scleroderma]] |
| | * [[Systemic lupus erythematosus (patient information)|Systemic lupus erythematosus]] (SLE) |
|
| |
|
| It is important to note that not everyone who develops these bacterial infections will develop reactive arthritis. In fact, reactive arthritis only develops in a minority of individuals exposed to one of the causative organisms. Researchers do not know exactly why some people develop reactive arthritis, while others do not. Some individuals may have a genetic predisposition to developing the disorder. Researchers have determined that many affected individuals have a particular, genetically-determined “human leukocyte antigen” (HLA) known as ''HLA-B27''. HLAs are proteins that play an important role in the body’s immune system; they influence the outcome of organ transplants and appear to affect an individual’s predisposition to certain diseases. Specifically, the ''HLA-B27'' antigen is present in many individuals with reactive arthritis and related disorders. However, it is important to note that the majority of patients who develop reactive arthritis are ''HLA-B27 ''negative, so the genetic component of reactive arthritis is not fully understood. Some researchers believe that ''HLA-B27'' is a better indicator of disease severity rather than susceptibility.
| | ==Who is at highest risk?== |
| | Certain factors are associated with a greater risk of arthritis. Some of these risk factors are modifiable while others are not. |
| | Non-modifiable risk factors: |
| | *Age: The risk of developing most types of arthritis increases with age. |
| | *Gender: Most types of arthritis are more common in women; 60% of the people with arthritis are women. [[Gout]] is more common in men. |
| | *[[Genetic]]: Specific [[genes]] are associated with a higher risk of certain types of arthritis, such as [[rheumatoid arthritis]] (RA) and [[systemic lupus erythematosus]] (SLE), and [[ankylosing spondylitis]]. |
| | Modifiable risk factors |
| | *[[Overweight]] and [[Obesity]]: Excess weight can contribute to both the onset and progression of knee osteoarthritis. |
| | *Joint Injuries: Damage to a joint can contribute to the development of osteoarthritis in that [[joint]]. |
| | *Infection: Many microbial agents can infect joints and potentially cause the development of various forms of arthritis. |
| | *Occupation: Certain occupations involving repetitive [[knee]] bending and squatting are associated with [[osteoarthritis]] of the knee. |
|
| |
|
| Many people who have the ''HLA-B27'' gene do not develop reactive arthritis even after contracting one of the abovementioned infections, which suggests that additional genetic (e.g., additional genes), environmental and/or immunologic factors may all play a role in the development of reactive arthritis. More research is necessary to determine the exact, underlying mechanisms that cause reactive arthritis.
| | ==When to seek urgent medical care?== |
| | If you have pain, stiffness, or swelling in or around one or more of your joints, talk to your doctor. It is important to keep in mind that there are many forms of arthritis, and a specific diagnosis of the type you have may help to direct the proper treatment. Although there is no cure for most types of arthritis, early diagnosis and appropriate management are important, especially for inflammatory types of arthritis. For example, early use of disease-modifying drugs can affect the course of rheumatoid arthritis. An early diagnosis and appropriate treatment can make a difference in pain and joint damage. The earlier you understand your arthritis, the earlier you can start managing your disease and making healthy lifestyle changes to help your arthritis. |
|
| |
|
| == Affected Populations == | | ==Diagnosis== |
| Reactive arthritis most often affects white men between the ages of 20 and 40. However, it has also been reported in children and the elderly. Women usually develop milder symptoms and may often go undiagnosed. Men are estimated to be approximately nine times more likely to develop reactive arthritis following a sexually-acquired infection. The risk of developing reactive arthritis following a gastrointestinal infection is the same between men and women. The exact incidence of reactive arthritis is unknown and estimates vary. Some researchers believe that many cases often go misdiagnosed or undiagnosed.
| | The health care provider will perform a physical exam and ask questions about your medical history. |
|
| |
|
| Reactive arthritis has appeared in the medical literature under many different names including Reiter’s syndrome, named after a physician, Hans Reiter, who reported on the disorder in 1916. However, because of concerns about the unethical activities of Dr. Reiter in Germany during World War II, the term has gradually been replaced by the more appropriate and more descriptive term reactive arthritis.
| | The physical exam may show: |
|
| |
|
| == Related Disorders ==
| | * Fluid around a joint |
| Symptoms of the following disorders can be similar to those of reactive arthritis. Comparisons may be useful for a differential diagnosis.
| | * Warm, red, tender joints |
| | * Difficulty moving a joint (called "limited range of motion") |
|
| |
|
| Infectious arthritis, also known as septic arthritis, is a general term for joint inflammation that develops because of an infection in one or more joints. The symptoms of infectious arthritis depend on the specific infectious agent and specific joints involved. General symptoms common to many illnesses may occur including fever, chills, headaches, general weakness and a general feeling of poor health (malaise). These symptoms may precede the development of joint pain and swelling. Most often the infection begins at some other location in the body and travels via the bloodstream to the joint. Less commonly, the infection starts in the joint in the course of a surgical procedure, injection (or similar action), or trauma. Infectious arthritis can be caused by bacteria, viruses or, less frequently, fungi or parasites. (For more information on this disorder, choose “infectious arthritis” as your search term in the Rare Disease Database.)
| | Some types of arthritis may cause joint deformity. This may be a sign of severe, untreated rheumatoid arthritis. |
|
| |
|
| The spondyloarthropathies are a group of related disorder characterized by similar symptoms including arthritis, especially of the lower limbs, lower back pain and enthesitis, a condition characterized by inflammation at the spot where skeletal muscle attaches to bone. These disorders also are associated with a specific genetic marker known as ''HLA-B27''. The toes and/or fingers of affected individuals may become inflamed and swollen (dactylitis) so that they appear large and stubby. In addition to reactive arthritis, this group of disorders includes ankylosing spondylitis, psoriatic arthritis, undifferentiated spondyloarthritis, and spondyloarthritis associated with inflammatory bowel disease. (For more information on these disorders, choose the specific disorder name as your search term in the Rare Disease Database.)
| | Blood tests and joint x-rays are often done to check for infection and other causes of arthritis. |
|
| |
|
| A variety of other rheumatic and infectious diseases may cause joint inflammation and additional symptoms that can resemble those seen in reactive arthritis. These disorders include rheumatoid arthritis, adult-onset Still’s disease, osteoarthritis, gout and Lyme disease. (For more information on these disorders, choose the specific disorder name as your search term in the Rare Disease Database.)
| | Your doctor may also remove a sample of joint fluid with a needle and send it to a lab for examination. |
|
| |
|
| == Diagnosis == | | ==Treatment options== |
| There is no specific, conclusive diagnostic test for reactive arthritis. Several groups have published diagnostic guidelines for reactive arthritis. However, these guidelines are often in disagreement as to what specifically is required for a diagnosis. Specific, consistent diagnostic guidelines have yet to be established for reactive arthritis.
| | The focus of treatment for arthritis is to control pain, minimize joint damage, and improve or maintain function and quality of life. According to the American College of Rheumatology, the treatment of arthritis might involve the following: |
|
| |
|
| A diagnosis of reactive arthritis is made based upon identification of characteristic symptoms, a detailed patient history, a thorough clinical evaluation and a variety of specialized tests including blood tests, joint fluid tests, and specialized imaging tests. These tests can aid in a diagnosis of reactive arthritis or rule out the disorder. However, none of these tests is conclusive as to whether a person has the disorder or not. Blood tests can reveal certain findings associated with reactive arthritis, including:
| | *Medication |
| | *Nonpharmacologic therapies |
| | **Physical or occupational therapy |
| | **Splints or joint assistive aids |
| | **Patient education and support |
| | **Weight loss |
| | *Surgery |
|
| |
|
| The ''HLA-B27'' genetic marker: This genetic marker is associated with spondyloarthropathies including reactive arthritis. It can aid in the diagnosis of reactive arthritis, but not every person who has this marker develops the disorder.
| | ==Where to find medical care for Arthritis?== |
| | [http://maps.google.com/maps?q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|map+top+hospital+Arthritis}}}}&oe=utf-8&rls=org.mozilla:en-US:official&client=firefox-a&um=1&ie=UTF-8&sa=N&hl=en&tab=wl Directions to Hospitals Treating Arthritis] |
|
| |
|
| The presence of bacteria such as Chlamydia, which can cause reactive arthritis: However, because the symptoms of reactive arthritis often do not become apparent until after an individual has recovered from the infection, no signs of the infection may be present. If the patient had an acute diarrheal illness and tested positive for Salmonella, Shigella, Campylobacter, or Yersinia 1-6 weeks prior to the onset of symptoms, then this is a very good indicator the patient probably has post-enteric reactive arthritis.
| | ==What to expect (Outlook/Prognosis)?== |
| | A few arthritis-related disorders can be completely cured with proper treatment. |
|
| |
|
| An elevated sedimentation rate: Sedimentation rate is the time it takes red blood cells to settle on the bottom of a test tube. An elevated sedimentation rate is indicative of inflammation somewhere in the body, but cannot distinguish between disorders that cause inflammation. This is most useful during the acute stage of reactive arthritis and is typically normal with the chronic form of this condition.
| | Most forms of arthritis however are long-term (chronic) conditions. |
|
| |
|
| Rule out other conditions: Blood tests can reveal certain findings associated with other disorders that have similar symptoms to reactive arthritis such as rheumatoid arthritis, which is associated with a specific antibody called rheumatoid factor or an anti-cyclic citrullinate peptide (CCP) antibody, or lupus, which is associated with antinuclear antibodies.
| | ==Possible complications== |
| | Complications of arthritis include: |
|
| |
|
| Physicians may also test the fluid in the joints (synovial fluid). Examining synovial fluid is done to rule out an infection in the joint, assess the amount of inflammation in the joint, and rule out other conditions such as gout or other types of crystal-related arthritis.
| | * Long-term (chronic) pain |
| | * Disablity |
| | * Difficulty performing daily activities |
|
| |
|
| Physicians may also use specialized imaging techniques (x-rays) to aid in the diagnosis of reactive arthritis or to rule out other conditions. X-ray studies may reveal distinctive characteristics of spondyloarthropathies such as reactive arthritis including inflammation of the sacroiliac joints (sacroiliitis). X-ray examination can also rule out other conditions. It is important to note that the typical changes on x-rays can take months to develop so x-rays are less useful in the acute setting. Specialized imaging techniques that may be used include computed tomography (CT) scans, magnetic resonance imaging (MRIs), or ultrasound. These advanced imaging techniques are more useful at detecting early or acute changes.
| | ==Prevention of Arthritis== |
| | Depending on the form of arthritis, there are steps that can be taken to reduce your risk of arthritis. Maintaining an appropriate body weight has been shown to decrease the risk of developing osteoarthritis and gout. Protecting your joints from injuries or overuse can reduce the risk of osteoarthritis. |
|
| |
|
| == Standard Therapies == | | ==Sources== |
| | |
| === '''Treatment''' ===
| |
| The treatment of reactive arthritis is directed toward the specific symptoms that are apparent in each individual. Treatment may require the coordinated efforts of a team of specialists. Orthopedists, ophthalmologists, dermatologists, urologists, gynecologists and other health care professionals may need to systematically and comprehensively plan appropriate therapy.
| |
| | |
| Individuals with reactive arthritis may be treated with nonsteroidal anti-inflammatory drugs (NSAIDs), which include ibuprofen, naproxen sodium, and aspirin. NSAIDs can help minimize the inflammation and pain associated with reactive arthritis. Corticosteroids may be used to treat joint inflammation. Usually, corticosteroids are injected directly (locally) into the affected joints and/or around tendons to relieve severe inflammation. Topical corticosteroids, usually a cream or lotion, can be applied to skin abnormalities to reduce inflammation and promote healing. Systemic corticosteroids have generally been less effective than treating other types of inflammatory arthritis.
| |
| | |
| Physical therapy and exercise can be beneficial in promoting and improving joint function. Strengthening and range-of-motion exercises can be used to help preserve or improve joint function. These techniques can build muscle around the joints, which strengthens support, improve the flexibility of joints, and help to reduce joint stiffness.
| |
| | |
| Because reactive arthritis occurs following a bacterial infection, the use of antibiotics has been studied as a potential therapy. Antibiotics are prescribed to eradicate the bacterial infection that causes reactive arthritis. The type of antibiotic used depends on the type of infection. Studies into the benefit of prolonged antibiotic therapy for individuals with reactive arthritis have been inconsistent and inconclusive and, consequently, there is disagreement in the medical literature as to the overall value and benefit of antibiotic therapy for individuals with reactive arthritis. Recent data suggest that Chlamydia-induced reactive arthritis might respond to prolonged (6-month) administration of a combination of antibiotics.
| |
| | |
| === Investigational Therapies ===
| |
| Additional therapies have studied for individuals with reactive arthritis including disease modifying antirheumatic drugs and biologics including tumor necrosis antagonists. More research is necessary to determine to the long-term safety and effectiveness of such therapies for the treatment of individuals with reactive arthritis.
| |
| | |
| Disease-modifying antirheumatic drugs (DMARDs) have been used to treat individuals with reactive arthritis who do not respond to treatment with nonsteroidal anti-inflammatory medications. These drugs can help to relieve severe inflammation and joint pain. Drugs in this category include sulfasalazine and methotrexate. Sulfasalazine is the best studied of these drugs for the treatment of individuals with reactive arthritis.
| |
| | |
| In recent years, drugs known as biologics including tumor necrosis factor (TNF) inhibitors have been studied to treat individuals with spondyloarthropathies (although there have been no formal studies with anti-TNF therapy in reactive arthritis). Examples of these drugs include etanercept, adalimumab and infliximab. More studies have been conducted with these drugs for individuals with ankylosing spondylitis and psoriatic arthritis and in many cases affected individuals demonstrated rapid and significant improvement in symptoms. Other biologics including those that target a different inflammatory chemical in the body, interleukin-17 (e.g. secukinumab), have also been studied as a treatment for ankylosing spondylitis and psoriatic arthritis. The Food and Drug Administration (FDA) eventually approved Enbrel® (etanercept) for the treatment of individuals with ankylosing spondylitis and psoriatic arthritis. Very recently Cosentyx® (secukinumab) was also approved by the FDA as a treatment for these same two conditions. Although these drugs have proven well-tolerated and effective for individuals with related disorders, the effectiveness for reactive arthritis has yet to be established.
| |
| *http://www.cdc.gov/arthritis/index.htm | | *http://www.cdc.gov/arthritis/index.htm |
| *http://www.nlm.nih.gov/medlineplus/ency/article/001243.htm | | *http://www.nlm.nih.gov/medlineplus/ency/article/001243.htm |
| Line 97: |
Line 105: |
| :*[[Gout (patient information)]] | | :*[[Gout (patient information)]] |
| :*[[Rheumatoid arthritis (patient information)]] | | :*[[Rheumatoid arthritis (patient information)]] |
| | |
|
| |
|
| [[Category:Disease]] | | [[Category:Disease]] |
For the WikiDoc page for this topic, click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jinhui Wu, M.D.; Ujjwal Rastogi, MBBS [2]; Ethan Leeman
Overview
Arthritis and other rheumatic conditions are more than 100 rheumatic diseases and conditions that affect joints, the tissues which surround joints and other connective tissue. The pattern, severity, and location of symptoms can vary depending on the specific form of the disease. Typically, rheumatic conditions are characterized by pain and stiffness in and around one or more joints. The symptoms can develop gradually or suddenly. Certain rheumatic conditions can also involve the immune system and various internal organs of the body.
The most common form of arthritis in the Unites States is osteoarthritis followed by gout, fibromyalgia, and rheumatoid arthritis. Currently, an estimated 46 million Americans reported that their doctor told them they had arthritis, and is expected to increase.
What are the symptoms of Arthritis?
The pattern and location of symptoms can vary depending on the type of arthritis. Generally, people with arthritis feel pain and stiffness in and around one or more joints. The onset of arthritis symptoms can develop gradually or suddenly. Arthritis is most often a chronic disease, so symptoms may come and go, or persist over time.
What causes Arthritis?
Arthritis involves the breakdown of cartilage. Cartilage normally protects a joint, allowing it to move smoothly. Cartilage also absorbs shock when pressure is placed on the joint, such as when you walk. Without the normal amount of cartilage, the bones rub together, causing pain, swelling (inflammation), and stiffness.
Joint inflammation may result from:
- An autoimmune disease (the body's immune system mistakenly attacks healthy tissue)
- Broken bone
- General "wear and tear" on joints
- Infection, usually by the bacteria or virus
Usually the joint inflammation goes away after the cause goes away or is treated. Sometimes it does not. When this happens, you have chronic arthritis. Arthritis may occur in men or women. Osteoarthritis is the most common type. See: Osteoarthritis
Other, more common types of arthritis include:
Who is at highest risk?
Certain factors are associated with a greater risk of arthritis. Some of these risk factors are modifiable while others are not.
Non-modifiable risk factors:
Modifiable risk factors
- Overweight and Obesity: Excess weight can contribute to both the onset and progression of knee osteoarthritis.
- Joint Injuries: Damage to a joint can contribute to the development of osteoarthritis in that joint.
- Infection: Many microbial agents can infect joints and potentially cause the development of various forms of arthritis.
- Occupation: Certain occupations involving repetitive knee bending and squatting are associated with osteoarthritis of the knee.
When to seek urgent medical care?
If you have pain, stiffness, or swelling in or around one or more of your joints, talk to your doctor. It is important to keep in mind that there are many forms of arthritis, and a specific diagnosis of the type you have may help to direct the proper treatment. Although there is no cure for most types of arthritis, early diagnosis and appropriate management are important, especially for inflammatory types of arthritis. For example, early use of disease-modifying drugs can affect the course of rheumatoid arthritis. An early diagnosis and appropriate treatment can make a difference in pain and joint damage. The earlier you understand your arthritis, the earlier you can start managing your disease and making healthy lifestyle changes to help your arthritis.
Diagnosis
The health care provider will perform a physical exam and ask questions about your medical history.
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.
Blood tests and joint x-rays are often done to check for infection and other causes of arthritis.
Your doctor may also remove a sample of joint fluid with a needle and send it to a lab for examination.
Treatment options
The focus of treatment for arthritis is to control pain, minimize joint damage, and improve or maintain function and quality of life. According to the American College of Rheumatology, the treatment of arthritis might involve the following:
- Medication
- Nonpharmacologic therapies
- Physical or occupational therapy
- Splints or joint assistive aids
- Patient education and support
- Weight loss
- Surgery
Where to find medical care for Arthritis?
Directions to Hospitals Treating Arthritis
What to expect (Outlook/Prognosis)?
A few arthritis-related disorders can be completely cured with proper treatment.
Most forms of arthritis however are long-term (chronic) conditions.
Possible complications
Complications of arthritis include:
- Long-term (chronic) pain
- Disablity
- Difficulty performing daily activities
Prevention of Arthritis
Depending on the form of arthritis, there are steps that can be taken to reduce your risk of arthritis. Maintaining an appropriate body weight has been shown to decrease the risk of developing osteoarthritis and gout. Protecting your joints from injuries or overuse can reduce the risk of osteoarthritis.
Sources
See also
Template:WH
Template:WS