DIFFERENT TYPES OF ARTHRITIS
The joints are affected by over 100 different conditions and are broadly called arthritis. Arthritis is a joint inflammation that can lead to debilitating pain in the joints, which affects the joints, tissues around the joint, and other connective tissues. Many symptoms of arthritis include pain, aching, stiffness, and swelling. Symptoms impair a person’s ability to perform everyday tasks. Factors in arthritis progression include injury, irregular metabolism, genetic makeup, infections, and the disorder of the immune system. Osteoarthritis is the most common type of Arthritis. Other common arthritis-related rheumatism disorders include gout, fibromyalgia, and rheumatoid arthritis (RA). Some types of arthritis can affect multiple organs and cause widespread symptoms, such as rheumatoid arthritis and lupus (SLE). Arthritis is more common among old ages, but it can affect people of all ages, including children. Treatment is intended to manage pain, reduce damage to the joints, and enhance or preserve the quality of life. It includes medication, physical therapy, educating, and supporting patients. It’s crucial to analyze what type of arthritis you have to determine the best treatment and management strategies.
Osteoarthritis is the most common type of joint disease, also called degenerative arthritis. It affects the entire joint including bone, ligaments, cartilage, and muscles. It’s the “wear and tear” that happens with age, but it can also be due to joint injuries, joint overuse, family history, or obesity, which can place extra stress on the joints eg;-In an obese person, the excess weight put more pressure on the cartilage as it squeezes itself between the bones. It becomes damaged and wears away and the joint doesn’t have as much left to cushion it. The affected cartilage causes painful movement. As the roughened cartilage on the surface of the bones rubs together you can hear a grating sound, may get painful bumps or spurs at the end of the bones. Knees, hips, feet, and spine are the most commonly affected positions. This often occurs over months or years, slowly. Osteoarthritis sufferers may develop the following symptoms
- Pain(deep and aching) and joint stiffness
- Pain that gets more worse on exercises or pressure on the joint
- Difficulty in dressing, hair combing, bending, squatting, or climbing stairs, depends on the joints involved.
- Rubbing, grating, or crackling sound while moving a joint
- Morning stiffness less than 30 minutes
- Stiffness after resting
- Pain causes sleep disturbance
- Joint could be warm, swollen, and more difficult to move, unable to move in a full range of motion.
Rheumatoid arthritis (RA)
RA is an autoimmune disease. This means that the immune system targets parts of the body, in particular the joints. It results in inflammation, which can cause severe joint damage. The most often affected are the joints of the wrists, fingers, knees, feet, and ankles. In the end, joint deformities may develop. May slowly come on, or suddenly start. Often they’re more serious than osteoarthritis. RA may happen at any age and is associated with fatigue and prolonged post-rest stiffness. RA causes early death and disability and can adversely affect living standards. Conditions it is associated with include cardiovascular diseases, such as heart disease and stroke. Early diagnosis of RA provides a better chance to learn how to effectively manage the symptoms. This may help decrease disease’s impact on the quality of life. Symptoms occur on joints include
- Morning stiffness, lasting longer than 1 hour
- Pain often in identical joints on both sides of the body
- Reduced range of motion of joints, probably with deformity
People may also develop additional symptoms in other areas of the body, such as the heart, lungs, eyes, or skin. Often, Sjögren’s syndrome occurs with RA. This condition causes mouth and eyes severely dry. Nodules under the skin, generally a sign of more severe illness. Other symptoms include numbness, tingling, or burning in the hands and feet and reduced sleep.
Gout is a type of arthritis caused by the accumulation of uric acid crystals inside the joints, or monosodium urate crystals. This occurs when too much uric acid is formed by the body, or not enough uric acid is excreted. The risk of developing gout can be affected by age, diet (a diet rich in meat and seafood), alcohol consumption, overweight or obesity, medications, stress, or other disease and family history. A gout attack typically happens very quickly, often overnight. The joint is getting very red, swollen, and very painful. Gout usually affects one joint at a time, most often the big toe joint. Although if don’t treat it, the threat will last between 3 and 10 days. It may be months or years before you have another, but attacks may increase more frequently over time. And they too will last longer. If gout goes too long untreated it can damage joints (Recurrent attacks of acute gout can lead to a degenerative form of chronic arthritis called Gouty arthritis) and kidneys.
Gout symptoms include
- Pain and swelling, often at big toes, knee or ankle joints
- Sudden, often night-time pain that can be throbbing, crushing, or excruciating.
- Warm and tender joints with the red and swollen appearance
- Fever happens occasionally
An individual may develop tophi after having gotten gout for several years. Tophi are lumps beneath the skin, usually around the joints or visible on the fingertips and ears. Multiple, small tophis, or a large white lump, may develop. That can cause the skin to deform and stretch. Often, tophi spontaneously burst out and drain, oozing a white, chalky substance. Tophi which start breaking through the skin may lead to infection or osteomyelitis. Many patients will require immediate surgery to get the tophus removed.
Ankylosing spondylitis (AS) as well as other forms are autoimmune diseases that can affect the positions where bone tendons and ligaments are attached. And the condition that mainly affects the spine. Neck, back, and pelvic joints are inflamed, leading to pain and stiffness. Certain joints, such as hips and shoulders and other parts of the body such as the eyes, skin, intestines, and lungs, may also be involved. Symptoms of AS typically start between age 15 and age 45. Bone fusion can occur in AS, causing spine deformation and shoulders and hip dysfunction. Spondylitis ankylosing is a hereditary disorder. Many individuals who acquire AS have the gene HLA-B27. It is more common in men than in women.
Systemic lupus erythematosus (SLE)
The systemic lupus erythematosus ( SLE) is another autoimmune condition that may affect joints and other forms of body connective tissue. Certain organs such as lungs, skin, kidneys, blood vessels, heart, brain, etc. may also be affected. The disease is characterized by periods of illness and remissions. Women of reproductive age, especially those with African or Asian ancestry, are much more probable to get lupus than men. It typically shows up between the ages of 15 and 44. Common symptoms include pain and swelling in the joints. The cause remains uncertain but it may be linked with genetic, environmental, and hormonal factors.
Other symptoms include:
- Chest pain when respiration deeply due to inflammation of the lining of the heart or lung.
- Red rash or color change on the face, sometimes as a butterfly over the nose and cheeks.
- Painful or swelled joints and lymph nodes.
- Unexplained fever
- Extreme fatigue
- Unusual hair loss
- Feeling of anxiety or discomfort.
- Mouth sores
- sensitivity to the sunlight
- pale or purple fingers or toes from cold or stress
- low blood count
- Swelling in the feet, legs, hands, or around the eyes
- Depression, trouble thinking or memory problems
- Unexplained seizures
- Repeated miscarriages
- Unexplained kidney problems
Psoriatic arthritis (PsA)
Psoriatic arthritis is a medical condition that causes joints to become inflamed. It causes painful, stiff, and sometimes swollen joints. Psoriatic arthritis typically only affects people with a skin condition called psoriasis. Psoriatic arthritis (PsA) will often affect up to 30 percent of those with psoriasis. Psoriasis is usually encountered before PsA sets in, but joint issues may occur occasionally prior skin lesions appear. PsA generally starts between the ages of 30 and 50 but it can come as early as childhood. It’s equally common among both men and women. The fingers are most frequently affected, but the painful problem often affects other joints. There may also be pink-colored fingers that look sausage-like and pitting and fingernail degradation. Severe psoriasis can affect many joints, including the spine. Symptoms of the spine are generally felt on the lower spine and sacrum. Those consist of stiffness, burning, and pain, causing damage similar to that of ankylosing spondylitis. People with psoriatic arthritis generally have a higher amount of cardiovascular disease risk factors compared to the general population including increased BMI, triglycerides, and C-reactive protein.
This is not clear what exactly causes psoriatic arthritis. Genetic history is one cause, but it seems to involve an attack on healthy cells and tissue by the immune system. The irregular immune response triggers joint inflammation, and skin cell overproduction. This can result in injury to joints.
Juvenile arthritis (JA)
JA is an umbrella word for different forms of arthritis affecting children. The most severe type is JIA (juvenile idiopathic arthritis), commonly known as juvenile rheumatoid arthritis. This is a category of autoimmune disorders that can affect the joints of children. JIA begins happening in children below the age of 16. It can cause tightening of the muscle and soft tissue, eroding of bones, changing growth patterns, misaligning joints. Months of painful joints, swelling, stiffness, fatigue, and fevers can signify juvenile idiopathic arthritis.
Symptoms of JA include
- A swollen, red or warm joint
- A joint which is stiff or reduced in motion
- Limping or having trouble using an arm or leg
- A sudden high fever which could come and go
- A rash that comes and goes with fever on the trunk and the extremities
- Symptoms, such as pale skin, swollen lymph glands throughout the body
- Often seeming unwell
Also, juvenile RA may cause eye problems, such as uveitis, iridocyclitis, or iritis.
Other forms of JA which are less common include
- Juvenile dermatomyositis(JDM) is a rare condition that causes inflammation of the skin and muscle.
- Juvenile lupus (Juvenile SLE) is Diagnosing Systemic Lupusin Children.
- Juvenile scleroderma is an inflammatory disease affecting the skin
- Kawasaki disease causes inflammation in the blood vessels throughout the body.
- Mixed connective tissue disease
Septic arthritis is a joint inflammation caused by bacteria, viruses, parasites, or fungi, causes pain or swelling. It can happen when an infection in one part of the body causes dysfunction of the immune system and inflammation elsewhere in the body in a joint. Often, the infection occurs in the gastrointestinal tract, bladder, or sex organs may develop when bacteria or other microorganisms that cause disease spread via the blood to a joint, or when the joint is specifically infected with a microorganism through injury or surgery. Fever and chills frequently follow this type of arthritis. It most frequently occurs in the hip and knee. Most cases of acute septic arthritis cause bacteria such as Staphylococcus, Streptococcus, or Neisseria gonorrhoeae. Organisms like Mycobacterium tuberculosis and Candida albicans cause chronic septic arthritis. This is less common as compared to acute septic arthritis.
Septic arthritis can develop at any age. It may occur in infants before age 3. At this period the hip is a common infection site. Septic arthritis from 3 years to puberty is rare. Children with septic arthritis are more likely to get infected with Group B Streptococcus or Haemophilus influenzae than adults unless they have been vaccinated ( influenzae b-Hib vaccine). Septic arthritis is an emergency in rheumatology, as it can lead to rapid joint destruction. Can be fatal.
The following conditions make septic arthritis more vulnerable to developing:
- Existing joint illness or injury
- Artificial joint implants
- Bacterial infection another part of the body
- Bacterial presence in blood
- Chronic disease (e.g., diabetes, RA and sickle cell disease)
- Intravenous (IV) or drug-injection
- Medicines can suppress the immune system
- Recent joint injury
- Recent joint-arthroscopy or other operations
- Conditions like HIV which weaken the immunity
- Old people
Symptoms are include
- inability to move the infected joint
- Intense pain, swelling, and redness in the joint
- Chills occur occasionally but are an unusual symptom.
Fibromyalgia syndrome is a specific category of symptoms characterized by generalized pain and muscle stiffness, as well as intense fatigue, in which the brain regulates muscle and joint pain in a way that amplifies pain perception It can vary from very mild to severe and can last for several years or may come and go at different times. It typically starts during or after middle age but can affect children. It is more common among women. There may also be tingling or numbness in the hands and feet, pain in the jaw, and digestive problems.
Common symptoms include
- Widespread pain, mostly with specific points of tenderness
- Tingling in hands and feet, or numbness
- Morning stiffness
- Sleep disturbance
- Headaches or migraine
- Irritable bowel syndrome
- Psychological stress
- Thought and memory problems, sometimes called “fibro-fog”
- Painful menstrual cycles and other syndromes of pain
Reason for fibromyalgia is unclear but certain factors have been strongly linked with the development of the disease:
- Activities that are stressful or traumatic
- Lesions caused by repeated movements
- Post-traumatic stress disorder (PTSD)
- Disease, such as viral infections
- Having lupus, RA, or chronic fatigue syndrome
- The history of the family
The word ‘scleroderma’ means ‘hard skin’, is an autoimmune disease where inflammation and hardening of the connective tissues of skin can result in organ damage and joint pain. Symptoms differ greatly from individual to individual and also vary on what part of the body is involved. The cause is not yet understood. Often it affects people aged between 30 and 50 years.
Other types of arthritis
- Polymyalgia rheumatica- shows ‘pain in many muscles.’ It is a condition that affects the joints and tissues around the joints to become inflamed. This causes the muscles to feel painful and stiff, particularly in areas of the shoulder, neck, and hip. Polymyalgia rheumatica is different from fibromyalgia, which is not an inflammatory condition.
- Charcot joint-is a condition in which a weight-bearing joint is progressively destroyed by insufficient innervation, resulting in deformities and pathological fractures
- Osteochondromatosis – caused by the proliferation and transformation of the synovial membrane into osteogenic tissue, leading to several bony projections forming from the joint lining and eventually forming loose bodies, and osteoarthritis
- Behcet ‘s syndrome – uncommon and devastating autoimmune disease that causes sores in the mouth and the genital organs, with inflammation of the eyes and rashes
- Ross River virus and Barmah Forest virus- are infections that spread via mosquito bites to humans. They cause related diseases like inflammation of the joints and pain. Persons of all ages are at risk for such infections. Ross River virus is Australia’s most common and widespread mosquito-borne disease infecting humans.
- Adult-onset Still’s disease – similar to systemic-onset juvenile rheumatoid arthritis, it begins in adult life.
- Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease – occurs in and around the joint with the deposition of these crystals, causing inflammation and cartilage breakdown
- Diffuse idiopathic skeletal hyperostosis (DISH) – caused by inflammation of the tendons and ligaments around the spine due to calcification and the development of bone spurs
- Whipple’s disease – a rare infection with Tropheryma whipplei that affects several organs, including the heart and lungs, along with joint pain
- Lesch-Nyhan syndrome – also known as juvenile gout, it is an inherited illness caused by an HGPRT enzyme deficiency that occurs mostly in males
- Ochronosis – caused by the accumulation of a metabolite called homogentisic acid in the connective tissues, which results in yellowish skin discoloration and arthritis, amongst many features
- Relapsing polychondritis – a multiple system disorder with recurrent inflammation and breakdown of the cartilage, often resulting in joint deformation
- Wegener’s granulomatosis – Is responsible for inflammation of small vessels in the upper respiratory tract, the lungs and the kidneys, and joint pain
- Hemochromatosis – iron overload damages the joints and other organs, including the pancreas and liver.
- Pigmented villonodular synovitis-an illness caused in most cases by inflammation and proliferation of the hip or knee joint lining
- Lipoid dermatoarthritis-the destruction of multiple joints due to a fat metabolism defect
- Sickle cell arthropathy – joint complications like gout or septic arthritis due to joint damage during sickle-cell crises
- Polyarteritis nodosa-a vasculitic disease that affects multiple systems and causes fever and night sweat with severe muscle and joint pain.