Arthritis (Joint Inflammation)

Picture of rheumatoid arthritis vs. osteoarthritis

Arthritisis a joint disorder featuring inflammation. A joint is an area of the body where two different bones meet. Joint functions to move the body parts connected by their bones. Arthritis literally means inflammation of one or more joints.

Arthritis is frequently accompanied byjoint pain．Jointpainis referred to as arthralgia. When four or more joints are involved, the arthritis is referred to as polyarthritis. When two or three joints are involved, it is referred to as oligoarthritis. When only a single joint is involved, it is referred to as monoarthritis.

There are many types of arthritis (over 100 identified). The types of arthritis range from those related to wear and tear of cartilage (such asosteoarthritis) to those associated with inflammation resulting from a misdirected immune system (such asrheumatoid arthritis). Whileosteoarthritisandrheumatoid arthritisare common types of arthritis, there are many other common and uncommon types of arthritis. Other types of inflammatory arthritis include:

• Psoriatic arthritis
• Ankylosing spondylitis
• Reactive arthritis
• Infectious arthritis(septic arthritisand Lyme arthritis)

Together, the many types of arthritis make up the most common chronic illness in the United States. Self-limited forms of arthritis can occur in association with virus infections.

The causes of arthritis depend on the type of arthritis and may include:

• Injury (leading to osteoarthritis)
• Metabolic abnormalities (such asgoutwith elevated uric acid blood levels andpseudogoutwithhypercalcemia)
• Hereditary factors
• Direct and indirect effects of infections (bacterial and viral)
• Misdirected immune system with autoimmunity (such as inrheumatoid arthritisandsystemic lupus erythematosus)

关节炎是归类为风湿性di之一seases. These are conditions that are different individual illnesses, with differing features, treatments, complications, and prognoses. They are similar in that they have a tendency to affect the joints, muscles, ligaments, cartilage, and tendons, and many have the potential to affect other internal body areas.

The major risk factors for most forms of arthritis are genes that areinheritedfrom ancestors.Trauma-related arthritis is related to the risk of injury from specific activities.

Symptoms of arthritis includepainand limited function of joints. Joint inflammation from arthritis is characterized byjoint stiffness, swelling, redness, pain, and warmth:

• Stiffnessof the joint can lead to poor function.
• Tenderness of the inflamed joint can be present with or without pain.
• When large joints are involved, such as the knee, there can be loss of cartilage with limitation of motion from the joint damage.
• When arthritis affects the small joints in the fingers, there can be bone growth and loss of hand grip and grip strength of the hand associated with stiffness.
• Arthritis of weight-bearing joints can lead to difficultywalkingfrom poor joint function and arthritis pain.

Many forms of arthritis, because they are rheumatic diseases, can cause symptoms affecting various organs of the body that do not directly involve the joints. Therefore, symptoms in some patients with certain forms of arthritis can also include:

• Fever
• Gland swelling (swollen lymph nodes)
• Weight loss
• Fatigue
• A grating sensation or “popping” sound when the joint moves
• Feeling unwell
• Symptoms of abnormalities of organs such as thelungs,heart, or kidneys

The first step in the diagnosis of arthritis is a meeting between the doctor and the patient.

• The doctor will review the history of symptoms, examine the joints for inflammation and deformity, as well as ask questions about or examine other parts of the body for inflammation or signs of diseases that can affect other body areas.
• Furthermore, medical professionals may order certain blood (C-reactive protein,sedimentation rate,rheumatoid factor, anti-CCP antibody, etc.), urine, joint fluid, and/or X-ray tests. Plain X-ray testing can be used to easily detect signs of osteoarthritis, such as joint space narrowing and spur formation (osteophytes).
• A doctor will make a diagnosis based on the pattern of symptoms, the distribution of the inflamed joints, and any blood and X-ray findings. Several visits may be necessary before the doctor can be certain of the diagnosis. A doctor with special training in arthritis and related diseases is called arheumatologist(see below).

Many types of arthritis are more of an annoyance than serious. However, millions of people suffer daily from pain and disability from arthritis or its complications.

Earlier and accurate diagnosis can help to prevent irreversible damage and disability. Properly guided programs ofexerciseand rest, medications, physical therapy, and surgery options can idealize long-term outcomes for those with arthritis.Exerciseand exercise routines can be helpful in providing joint stability by strengthening the musculoskeletal system while improving balance. Physical therapists can provide the care needed for properly guided exercise regimens.

It should be noted that both before and especially after the diagnosis of arthritis, communication with the treating doctor is essential for optimal health. This is important from the standpoint of the doctor so that he/she can be aware of the vagaries of the patient's symptoms as well as their tolerance of and acceptance of treatments. It is important from the standpoint of patients so that they can be assured that they have an understanding of the diagnosis and how the condition does and might affect them. It is also crucial for the safe use of medications.

A rheumatologist is a medical doctor who specializes in the non-surgical treatment of rheumatic illnesses, especially arthritis.

Rheumatologistshave special interests in unexplainedrash,fever, arthritis,anemia,weakness,weight loss,fatigue, joint ormuscle pain, autoimmune disease, andanorexia．They often serve as consultants, acting like medical detectives at the request of other doctors.

Rheumatologists have particular skills in the evaluation of the over 100 forms of arthritis and have special interests in inflammatory arthritis such as:

• Rheumatoid arthritis
• Seronegative arthritis
• Spondylitis
• Psoriatic arthritis
• Systemic lupus erythematosus
• Antiphospholipid syndrome
• Still's disease
• Dermatomyositis
• Sjögren's syndrome
• Vasculitis
• Scleroderma
• Mixed connective tissue disease
• Sarcoidosis
• Lyme disease
• Osteomyelitis
• Osteoarthritis
• Back pain
• Gout
• Pseudogout
• Relapsing polychondritis
• Henoch-Schönlein purpura
• Serum sickness
• Reactive arthritis
• Kawasaki disease
• Fibromyalgia
• Erythromelalgia
• Raynaud's disease
• Growing pains
• Iritis
• Osteoporosis
• Reflex sympathetic dystrophy

Classical adultrheumatologytraining includes four years of medical school, one year of internship in internal medicine, two years of internal medicine residency, and two years of rheumatology fellowship. There is a subspecialty board for rheumatology certification, offered by the American Board of Internal Medicine, which can provide board certification to approved rheumatologists.

• Pediatric rheumatologists are physicians who specialize in providing comprehensive care to children (as well as their families) with rheumatic diseases, especially arthritis.
• Pediatric rheumatologists are pediatricians who have completed an additional two to three years of specialized training in pediatric rheumatology and are usually board-certified in pediatric rheumatology.

Other doctors who treat arthritis include:

• Pediatricians
• Internists
• General medicine doctors
• Family medicine doctors
• Orthopedic surgeons

The treatment of arthritis is very dependent on the precise type of arthritis present. An accurate diagnosis increases the chances of successful treatment. Treatments available include:

• Physical therapy
• Home remedies
• Splinting
• Cold-pack application
• Paraffin wax dips
• Anti-inflammatorydrugs
• Pain medications (ranging from pain-relievingover-the-countermedications such asacetaminophen[Tylenol] andibuprofen[Motrin,Advil] to narcotics)
• Immune-altering medications
• Biologic medications
• Surgical operations (including joint replacement surgery)

Pain from osteoarthritis of the knee can be relieved byhyaluronic acidinjections. Rheumatoid arthritis can require medications that suppress the immune system (disease-modifying medications). Low back arthritis that is irritating the nerves of the spine can require surgical repair. For more on treatments of particular forms of arthritis, see the corresponding articles for the form of arthritis of interest.

The outlook for patients with arthritis depends on its severity, complications, and whether or not there are non-joint manifestations of the disease.

• For example, rheumatoid arthritis can affect the lungs, kidneys, eyes, etc.
• Chronic joint inflammation can lead to permanent damage to the joint and loss of joint function, making movement difficult or impossible.

Since most forms of arthritis are inherited to some degree, there is no real way to prevent them. Arthritis that follows joint injury could be prevented by adhering to safety regulations and trying to avoid becoming injured.

Arthritis related to infection (for example,septic arthritis,反应性关节炎,惠普尔氏病)prevented by not becoming infected with the causative organism. The extent to which this is possible varies depending upon the individual condition.

For most types of arthritis, diets play little or no role in precipitating or exacerbating the condition. However, in general, fish oils have been shown to have anti-inflammatory properties. Some osteoarthritis suffers benefit fromomega-3fatty acidsupplements．有些人热衷ple with osteoarthritis feel they benefit from the curcumin that is present in curry.

Goutis a particular type of metabolic arthritis that is clearlydiet-related. Foods that are high in purines, especially red meats and shellfish, can worsen the condition. Moreover, certain foods elevate the levels of uric acid, includingalcohol(especially beer) and those foods containing high amounts of fructose (such as thecornsyrup found in softdrinks).

For people withceliac disease,谷蛋白-containing foods (wheat, barley, rye) can worsen joint pain.

With the exception of the unique metabolic form of arthritis ingoutandceliac disease, there are no universally accepted foods that must be avoided by people with arthritis. That is, most foods are joint-friendly.

Gout, however, can be triggered and caused bydehydrationas well as fructose-containing foods (cornsyrup, etc.), high-purine foods (seafood, shellfish, organ meats), and alcoholicbeverages(particularly beer). People with gout should avoid these foods.

Arthritis associated withceliac diseasemay be worsened by the intake of gluten-containing foods (wheat, barley, rye).

The Arthritis Foundation is the only national voluntary health organization whose purpose is directed solely to all forms of arthritis. The Arthritis Foundation has national and international programs involving support for scientific research, public information and education for affected patients and their families, training of specialists, public awareness, and local community assistance.

Local branch chapters of the Arthritis Foundation serve to disseminate information about arthritis and rheumatic diseases, as well as function as referral centers. Moreover, many of the various forms of arthritis have their own foundations that serve as information and referral health resources for local communities.

It is the ultimate goal of scientific arthritis research that optimal treatment programs are designed for each of the many forms of arthritis. This field will continue to evolve as improvements develop in the diagnosis and treatment of arthritis and related conditions.