Joints can be rigid, such as the joints between the bones in the skull, or mobile, such as the joints in the knees, hips and shoulders.
Many joints have cartilage at the ends of the bones where they join. Healthy cartilage helps us move, allowing bones to “slide” on top of each other.
What Causes Arthritis?
There are many diseases where arthritis is the main feature. In other cases, arthritis is considered secondary to the underlying disease.
The two main types of diseases that have arthritis as their main symptom – Osteoarthritis and Rheumatoid Arthritis – damage the joints in different ways.
• OsteoarthritisOsteoarthritis affects the cartilage – the hard, gelatinous slippery tissue that covers the ends of the bones where they form a joint. It is a degenerative condition.
Osteoarthritis is a radiological finding in 80-90% of people over the age of 65. But the symptoms rarely appear before the age of 50. At the age of 55, women are more likely to suffer from osteoarthritis than men (ratio 1.7 / 1).
• Rheumatoid arthritis: Rheumatoid Arthritis is an autoimmune inflammatory disease caused by an overactive immune system. Rheumatoid arthritis affects not only the joints but also other organs of the body. It is estimated to affect 0.25-1% of the population and is 2 to 3 times more common in women. It usually occurs between 30 and 60 years, but also in children.
• Urinary tract disease: Gout is another complex condition. Uric acid crystals, which form when there is too much uric acid in the blood, can cause gout.
• Other causes: Other causes of arthritis are psoriatic arthritis, systemic lupus erythematosus and other rheumatic diseases.
Undifferentiated arthritis is an arthritis that does not belong to known categories of clinical diseases, it may be an early stage of a specific rheumatic disease.
Therefore, arthritis is usually a symptom of a systemic rheumatic disease, and its treatment depends mainly on the correct diagnosis.
What are the symptoms of Arthritis?
Pain, which can vary in severity, is a common symptom in almost all types of arthritis. In many cases, joint pain occurs in the form of the area around the joint being swollen, red, or hot to the touch. In addition, there may be reduced mobility and stiffness, especially in the morning.
The correct diagnosis is a function of the good clinical examination, the history (time of onset of pain, number and type of joints, etc.) but also the laboratory tests, which are the culmination of the other two elements.
Treatment varies depending on the type of arthritis and the type of disease that causes it.
The Rheumatologist, who is usually the main person responsible for dealing with it globally, should take into account all the above factors (history, clinical examination, laboratory tests).
The main goals of treating an arthritis-causing disease are the remission of the main disease which will lead to the treatment of symptoms in general (including arthritis) and the improvement of the quality of life.
Treatment of arthritis
Treatment usually starts with drugs that have the fewest side effects with the addition of further drugs, if they are not effective enough, and always taking into account the profile of each patient.
For rheumatoid arthritis, for example, the goal is to stop the course of the disease in time. This is achieved pharmaceutically with cortisone, disease-modifying drugs (DMARDs) and biological agents.
We should never consider, diagnostically and therapeutically, an inflamed joint (arthritis), as a single phenomenon, but as part of a disease of which it is a symptom.
Writes:
Komninou Eleni Rheumatologist
Head of the Department of Autoimmune Rheumatic Diseases of Pregnancy MITERA
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