Arthritis
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Arthritis Main Page |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Medical History and Physical Examination
All arthritides feature pain. Patterns of pain differ among the arthritides and the location.
Osteoarthritis is classically worse at night or following rest. Rheumatoid arthritis is generally worse in the morning; 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. Also, the nails beds turning a grey color, is associated with arthritis. Physical examination typically confirms diagnosis. Radiographs are often used to follow progression or assess severity in a more quantitative 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 arthritides are suspected. This may include: rheumatoid factor, antinuclear factor (ANF), extractable nuclear antigen and specific antibodies.
| Extra-articular features of joint disease [1] |
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| cutaneous nodules |
| cutaneous vasculitic lesions |
| lymphadenopathy |
| oedema |
| ocular inflammation |
| urethritis |
| tenosynovitis (tendon sheath effusions) |
| bursitis (swollen bursa) |
| diarrhea |
| oral and genital ulceration |
Blood tests and X-rays of the affected joints often are performed to make the diagnosis. Screening blood tests are indicated if certain arthritides are suspected. These might include: rheumatoid factor, antinuclear factor (ANF), extractable nuclear antigen, and specific antibodies.
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Differential Diagnosis of Joint Pain
- Acromegaly
- Acute tropical polyarthritis
- Alpha-interferon induced
- Alphaviruses
- Amyloidosis
- Ankylosing spondylitis
- Anticoagulant therapy
- Arboviruses
- Bacterial Endocarditis
- Behcet's Syndrome
- Calcium oxalate
- Calcium/phosphate crystals
- Crohn's Disease
- Degenerative joint disease
- Dermatomyositis
- Diabetes Mellitus
- Enterobacteriaceae
- Enteroviruses
- Epstein-Barr Virus
- Erythema Nodosum
- Fabry's Disease
- Familial Mediterranean Fever
- Foreign body
- Fungal infection
- Gaucher's Disease
- Gonococcus
- Gout
- Gram-Negative Bacilli
- Haemophilus influenzae
- Hemangioma
- Hemarthrosis
- Hemochromatosis
- Hemoglobinopathies
- Hemophilia
- Henoch-Schonlein Purpura
- Hepatitis A
- Hepatitis B
- Hepatitis C
- HIV
- Hydroxyapatite
- Hyperglobulinemic Purpura
- Hyperlipoproteinemia
- Hypogammaglobulinemia
- Hypothyroidism
- Hypotrophic osteoarthropathy
- Intermittent hydrarthrosis
- Juvenile Rheumatoid Arthritis
- Leukemia
- Loose joint body
- Lyme Arthritis
- Lymphoma
- Mixed Connective Tissue Disease
- Multiple Myeloma
- Mumps
- Neisseria gonorrhoeae
- Pallindromic rheumatism
- Pancreatic carcinoma
- Pancreatitis
- Parasitic infection
- Parvovirus B19
- Pigmented villondular synovitis
- Pneumococcus
- Polyarteritis Nodosa
- Polymyalgia Rheumatica
- Polymyositis
- Pseudogout
- Psoriasis
- Radiation
- Reiter's Syndrome
- Relapsing polychondritis
- Renal transplant
- Rheumatic Fever
- Rheumatoid arthritis
- Rickettsial infection
- Rubella
- Sarcoma
- Scleroderma
- Septic Arthritis
- Serum sickness
- Sjogren's Syndrome
- Staphylococcus
- Storage Disease
- Streptococcus
- Syringomyelia
- Systemic Lupus Erythematosus
- Tabes Dorsalis
- Tietze's Syndrome
- Trauma
- Tuberculosis
- Ulcerative colitis
- Varicella Zoster Virus
- Von Willenbrand's Disease
- Wegener's Granulomatosis
- Whipple's Disease
- Wilson's Disease
Treatment
Treatment options vary depending on the type of arthritis and include physical and occupational therapy, lifestyle changes (including exercise and weight control), and medications (symptomatic or targeted at the disease process causing the arthritis). Arthroplasty (joint replacement surgery) may be required in eroding forms of arthritis.
In general, studies have shown that physical exercising of the affected joint can have noticeable improvement in terms of long-term pain relief. Furthermore, exercising of the arthritic joint is encouraged to maintain the health of the particular joint and the overall body of the person.[2]
Another form of non-drug treatment that does have a body of proper research to support its efficacy is marine oil, from both fish and the New Zealand green-lipped mussel (Perna canaliculus). Diets high in marine oils from cold-water fish such as salmon, mackerel, and tuna have been shown to reduce the inflammation of joint conditions such as arthritis. Massage on joints with neem oil has reported improvement in chronic and acute cases.
References
- ↑ Swash, M, Glynn, M.(eds). 2007. Hutchison's Clinical Methods. Edinburgh. Saunders Elsevier.
- ↑ 6 reasons to exercise if you have arthritis
External links
- Arthritis Care
- Arthritis Research Campaign
- American College of Rheumatologists
- British Society for Rheumatology
- Arthritis Foundation
- Johns Hopkins Arthritis Center
- R.J. Fasenmyer Center for Clinical Immunology Cleveland Clinic Orthopaedic and Rheumatologic Institute
Template:Diseases of the musculoskeletal system and connective tissue
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