jueves, 6 de agosto de 2020

What is Arthritis?

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By Dr. Ananya Mandal, MDReviewed by April Cashin-Garbutt, MA (Editor)

There are over 100 disorders that typically affect joints, tendons, ligaments, bones, and muscles and are termed arthritis and rheumatic diseases. Some of these may also involve internal organs.

Forms of arthritis

Examples of arthritis include:

Rheumatoid arthritis
Osteoarthritis
Juvenile idiopathic arthritis
Fibromyalgia
Gout
Systemic lupus erythematosus (lupus)
Scleroderma
Spondyloarthropathies or ankylosing Spondylosis
Infectious arthritis
Polymyalgia rheumatic
Polymyositis
Psoriasis and Psoriatic arthritis
Inflammatory arthritis
Tendinitis
Bursitis

Causes of arthritis

Rheumatic diseases are myriad in their manifestations and causes. While some of these are genetic and a person may be predisposed to getting them or the arthritis may develop a trigger that causes arthritis. This could be an injury or an infection. A cold, flu, or other type of virus could trigger a rheumatic disease in some people. Osteoarthritis may be caused by wear and tear on the joints or by an injury to a joint.

Age and sex play a role in risk of getting arthritis. Some of the conditions are more common among elderly while some including osteoarthritis are more common in women after menopause.

Lupus, rheumatoid arthritis, scleroderma, and fibromyalgia are more common among women. Rheumatoid arthritis occurs two to three times more often in women than in men.

Gout is more common in men than in women. After menopause, the incidence of gout in women begins to rise. This could be due to the hormonal differences or due to genetic differences.

In addition, some races and ethnicities are more at risk. Lupus for example is more common in African Americans and Hispanics than in Caucasians.

Diagnosis of arthritis

Rheumatic diseases are diagnosed by regular physicians, orthopedicians as well as specialists in rheumatic diseases or a rheumatologist. Common signs and symptoms include:

Pain in one or more joints
Swelling in one or more joints. There may be warmth and redness in and around the joint.
Stiffness around the joints that lasts for at least 1 hour in the early morning after waking up. This is termed morning stiffness.
Constant or recurring pain
Difficulty using or moving a joint

Tests for arthritis

Tests commonly include:

routine blood tests
medical history
physical exam
X rays
imaging studies like CT scans and MRI of joints

Possible treatment

The common treatments that are applicable for most arthritis include rest, relaxation, physical therapy, monitored exercises and joint mobilization, healthy diet, weight loss.

Other therapies include water therapy, health and cold therapy, care for joints, devices such as splints, braces, crutches etc.

Patients may undergo surgery to restore function or to relieve pain and sometimes to introduce prosthetic joint replacements for better mobility. A plan of therapy is developed in conjunction with the patient and a multidisciplinary team.

Drugs are used in many forms of arthritis. The type of drug depends on the condition and on the individual patient. Most of these drugs do not provide a cure but rather limit the symptoms. One of the exceptions is arthritis that is caused by an infection, in which antibiotics can cure the condition.

Commonly used drugs in arthritis include pain relievers that may be applied locally over the skin or taken as pills. In rheumatoid arthritis, Disease-modifying antirheumatic drugs (DMARDs) and Biologic response modifiers may be tried. Corticosteroids are also used in many rheumatic conditions because they reduce swelling and block or slow down the immune system.

Other drugs used include Hyaluronic acid substitutes, nutritional supplements, enzyme inhibitors like Allopurinol (used in gout) etc.