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What is arthri­tis? What causes arthritis?

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

Arthri­tis is fre­quently accom­pa­nied by joint pain. Joint pain is referred to as arthralgia.

There are many types of arthri­tis (over 100 and grow­ing). The types range from those related to wear and tear of car­ti­lage (such as osteoarthri­tis) to those asso­ci­ated with inflam­ma­tion result­ing from an over­ac­tive immune sys­tem (such as rheuma­toid arthri­tis). Together, the many types of arthri­tis make up the most com­mon chronic ill­ness in the United States.

The causes of arthri­tis depend on the form of arthri­tis. Causes include injury (lead­ing to osteoarthri­tis), meta­bolic abnor­mal­i­ties (such as gout and pseudo­gout), hered­i­tary fac­tors, infec­tions, and unclear rea­sons (such as rheuma­toid arthri­tis and sys­temic lupus erythematosus).

Arthri­tis is clas­si­fied as one of the rheumatic dis­eases. 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.

What are symp­toms of arthritis?

Symp­toms of arthri­tis include pain and lim­ited func­tion of joints. Inflam­ma­tion of the joints from arthri­tis is char­ac­ter­ized by joint stiff­ness, swelling, red­ness, and warmth. Ten­der­ness of the inflamed joint can be present.

Many of the 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 (lymph node), weight loss, fatigue, feel­ing unwell, and even symp­toms from abnor­mal­i­ties of organs such as the lungs, heart, or kidneys.

Who is affected by arthritis?

Arthri­tis suf­fer­ers include men and women, chil­dren and adults. Approx­i­mately 350 mil­lion peo­ple world­wide have arthri­tis. Nearly 40 mil­lion peo­ple in the United States are affected by arthri­tis, includ­ing over a quar­ter mil­lion children!

More than 27 mil­lion Amer­i­cans have osteoarthri­tis. Approx­i­mately 1.3 mil­lion Amer­i­cans suf­fer from rheuma­toid arthritis.

More than half of those with arthri­tis are under 65 years of age. Nearly 60% of Amer­i­cans with arthri­tis are women.

How is arthri­tis diag­nosed, and why is a diag­no­sis important?

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, cer­tain blood, urine, joint fluid, and/or X-ray tests might be ordered. The diag­no­sis will be 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 a rheuma­tol­o­gist (see below).

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

Ear­lier and accu­rate diag­no­sis can help to pre­vent irre­versible dam­age and dis­abil­ity. Prop­erly guided pro­grams of exer­cise and rest, med­ica­tions, phys­i­cal ther­apy, and surgery options can ide­al­ize long-term out­comes for arthri­tis patients.

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.

How is arthri­tis treated?

The treat­ment of arthri­tis is very depen­dent on the pre­cise type of arthri­tis present. An accu­rate diag­no­sis increases the chances for suc­cess­ful treat­ment. Treat­ments avail­able include phys­i­cal ther­apy, splint­ing, cold pack appli­ca­tion, paraf­fin wax dips, anti inflam­ma­tion med­ica­tions, immune-altering med­ica­tions, and sur­gi­cal operations.

What is a rheumatologist?

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

Rheuma­tol­o­gists have spe­cial inter­ests in unex­plained rash, fever, arthri­tis, ane­mia, weak­ness, weight loss, fatigue, joint or mus­cle pain, autoim­mune dis­ease, and anorexia. 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 rheuma­toid arthri­tis, spondyli­tis, pso­ri­atic arthri­tis, sys­temic lupus ery­the­mato­sus, antiphos­pho­lipid syn­drome, Still’s dis­ease, der­mato­myosi­tis, Sjogren’s syn­drome, vas­culi­tis, scle­ro­derma, mixed con­nec­tive tis­sue dis­ease, sar­coido­sis, Lyme dis­ease, osteomyelitis, osteoarthri­tis, back pain, gout, pseudo­gout, relaps­ing poly­chon­dri­tis, Henoch-Schonlein pur­pura, serum sick­ness, reac­tive arthri­tis, Kawasaki dis­ease, fibromyal­gia, ery­throme­lal­gia, Raynaud’s dis­ease, grow­ing pains, iri­tis, osteo­poro­sis, reflex sym­pa­thetic dys­tro­phy, and others.

Clas­si­cal adult rheuma­tol­ogy train­ing 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.

Arthri­tis At A Glance

* Arthri­tis is inflam­ma­tion of one or more joints.
* Symp­toms of arthri­tis include pain and lim­ited func­tion of joints.
* Arthri­tis suf­fer­ers include men and women, chil­dren and adults.
* A rheuma­tol­o­gist is a med­ical arthri­tis expert.
* Ear­lier and accu­rate diag­no­sis can help to pre­vent irre­versible dam­age and disability.

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