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 forms of arthritis (over one hundred and growing). The forms range from those related to wear and tear of cartilage (such as osteoarthritis) to those associated with inflammation resulting from an over-active immune system (such as rheumatoid arthritis). Together, the many forms 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), abnormal metabolism (such as gout and pseudogout), inheritance, infections, and for 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 prognosis. They are similar in that they have a tendency to affect the joints, muscles, ligaments, cartilage, tendons, and many have the potential to affect internal body areas.

Different Types of Arthritis

Rheumatoid arthritis – is a disease that causes inflammation of the joints, usually in the hands, feet and knees. It can also affect other organs in the body. It usually develops between the ages of 25 and 50 years. While the cause is unknown, what appears to happen is that the body’s immune system attacks the body’s own tissues, rather than fighting diseases. When this happens, the tissue surrounding a joint (the ‘synovial membrane’) becomes inflamed and thickened. This causes the body to produce larger than normal amounts of fluid in the joints (‘synovial fluid’) which leads to swelling, pain and stiffness.

Osteoarthritis – can affect any joint in the body but it usually occurs in large weight-bearing joints such as hips, knees, shoulders and the lower spine. Osteoarthritis occurs when a joint between two bones becomes worn. In a healthy joint, the ends of the bones are covered by a smooth layer of cartilage. The cartilage stops the bones grating together and helps the joint move smoothly. The cartilage also cushions the bones. When the cartilage becomes damaged, its surface becomes rough, so that the joint cannot move smoothly. The cartilage also becomes weaker, leading to inflammation, pain and swelling

Gout – Gout normally affects the joint of the big toe first, although it can go on to affect the knees, ankles and hands. Gout is caused when tiny crystals of uric acid crystallise in the joints. This causes irritation and tissue inflammation. Uric acid is a waste product produced by the body, which is filtered through the kidneys and removed via urine. When higher than normal uric acid is produced, it is unable to be filtered out and crystallises in the joints and other organs of the body. The crystals can also permanently damage the cartilage of the joint, leading to osteoarthritis.

Fibromyalgia – Fibromyalgia syndrome is a common form of generalised muscular pain and fatigue. The name ‘fibromyalgia’ means pain in the muscles and the fibrous connective tissue (ligaments and tendons). Fibromyalgia is especially confusing and often misunderstood because almost all its symptoms are also common in other conditions, and it does not have a known cause. Fibromyalgia is a form of ‘soft tissue’ or muscular rheumatism rather than ‘arthritis of a joint’.

Lupus - affects various parts of the body, including the internal organs as well as usually producing a mild rash or flush on the face. Something goes wrong with the immune system which normally protects the body against harmful agents. This system consists of various white blood cells and others which circulate in the lymphatic tissues as well as the blood. They act as a form of radar to ’spot’ enemy microbes and then help to destroy them. Due to a case of ‘mistaken identity’ an immune attack is mounted against body’s own tissues. Auto-antibodies (a form of protein which bind to the body’s own tissues) are produced and circulate in the blood. They are associated with damage to the body. If they end up in the skin various rashes occur. Alternatively they can cause harm if they stick to the walls of blood vessels and can upset the function of the kidney, lungs, joints and occasionally the brain.

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, 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 persons in the United States are affected by arthritis, including over a quarter million children!

More than 21 million Americans have osteoarthritis. Approximately 2.1 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.

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 to 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.

Who is at risk?

There is no definite list of criteria which allow us to determine who might develop arthritis, however some of the risk factors that can cause arthritis include:

• Genetics
  While genetics may play a part in susceptibility, it is currently not known to what extent genetics contributes to the cause of arthritis


• Age
  While arthritis is not simply an elderly person’s disability, as people grow older they are more likely to develop arthritis – particularly osteoarthritis. This is simply because an older person will have had more wear and tear on their joints, leaving their cartilage more brittle and less likely to repair itself, than in a younger person.


• Weight
  Overweight people are more likely to develop osteoarthritis because they are placing a heavier load on their joints. This can cause certain body parts, such as hips and knees, to wear more quickly.


• Gender
  Women are more likely to develop arthritis than men.


• Previous Injury
  Previous major injuries, especially those which have caused damage to a joint, can be part of the cause of arthritis.