Arthritis (patient information)

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 * Associate Editor(s)-In-Chief:Jinhui Wu, M.D.; Ujjwal Rastogi, MBBS [mailto:urastogi@perfuse.org]; Assistant Editor-In-Chief: 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:
 * Ankylosing spondylitis
 * Gonococcal arthritis
 * Gout
 * Juvenile rheumatoid arthritis (in children)
 * Other bacterial infections (nongonococcal bacterial arthritis)
 * Psoriatic arthritis
 * Reactive arthritis (Reiter syndrome)
 * Rheumatoid arthritis(in adults)
 * Scleroderma
 * Systemic lupus erythematosus (SLE)

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.

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.