Arthritis

Osteoarthritis: Because osteoarthritis develops slowly, many patients do not experience symptoms right away. Once symptoms develop, they are generally the worst during the first year of the disease. Common symptoms include joint pain, swelling and/or stiffness in a joint (especially after use), joint discomfort before or during a change in the weather, bony lumps on the fingers, and loss of joint flexibility. The joints that are most often affected by osteoarthritis include the fingers, spine, and weight-bearing joints, such as the hips, ankles, feet, and knees.

If patients overuse the affected joints and do not receive treatment, the cartilage in the joints may wear down completely. When this happens, the bone may rub against bone, causing severe pain.

Rheumatoid arthritis: Rheumatoid arthritis often affects many joints at the same time. The severity of symptoms varies among patients. Symptoms, which may come and go, typically include pain and swelling in the joints (especially in the hands and feet), generalized aching or stiffness of the joints and muscles (especially after periods of rest), loss of motion of the affected joints, weakness in the muscles near the affected joints, low-grade fever, and general feeling of discomfort. In general, both sides of the body are affected equally. For instance, if arthritis is in the hands, both hands will be equally affected. Early in the disease, the joints in the hands, wrists, feet, and knees are most frequently affected. Over time, arthritis may develop in the shoulders, elbows, jaw, hips, and neck.

Over time, the joints may become deformed. Small lumps, called rheumatoid nodules, may develop under the skin at pressure points. These lumps, which range from the size of a pea to a quarter, may be visible near the elbows, hands, feet, Achilles tendons, back of the scalp, knee, or lungs. Rheumatoid nodules are not painful. However, bone deformities or swelling may reduce the flexibility of the joints.

In addition to the joints, other areas of the body may also be affected. Rheumatoid arthritis may cause swelling in other parts of the body, including the tear ducts, salivary glands, the lining of the heart, the lungs, and occasionally, blood vessels.

Periarthritis: Periarthritis causes swelling and pain in the joint. Most patients develop periarthritis of the shoulder. When the shoulder is affected, the joint's mobility is significantly or completely reduced aggressive treatment is started.

General: Once patients are diagnosed with arthritis, they should visit their healthcare providers regularly, at least once a year. Patients should stay in close contact with their physicians to ensure that their symptoms are managed and to monitor joint damage.

Osteoarthritis: X-rays are often the first test performed if a patient has symptoms of osteoarthritis. If the patient has osteoarthritis, the X-ray images will often show loss of cartilage in the affected joints, narrowing of the space between bones, and bumps called nodules.

A procedure called arthrocentesis may also be performed at a healthcare provider's office. During the procedure, a needle is inserted into the affected joint and a small sample of fluid is removed. The fluid is then analyzed to rule out other conditions, such as gout or infection. This test may also temporarily relieve some pain and inflammation in the joint.

A surgical procedure called arthroscopy may also be performed. During the surgery, a small incision is made into the affected joint. Then a tube called an arthroscope is inserted into the joint. This tube has a small light and camera, which allow the healthcare provider to see the inside of the joint. If abnormalities such as cartilage or ligament damage are seen, the patient is diagnosed with osteoarthritis.

Rheumatoid arthritis: A blood test may be performed to determine if an antibody called the rheumatoid factor is present. Most patients with rheumatoid arthritis eventually have this abnormal protein in their blood. However, it may not present when symptoms first develop. If rheumatoid factor is present, a positive diagnosis is made. If patients test negative but rheumatoid arthritis is suspected, a healthcare provider may recommend treatment to reduce symptoms. Another test may be performed in the future to confirm a diagnosis.

Periarthritis: Periarthritis is usually diagnosed after a healthcare provider takes a detailed medical history and performs a physical examination. The affected joint will have very limited mobility. In some cases, an X-ray may be needed to confirm a diagnosis. During the procedure, a contrast dye is injected into the affected joint and X-rays are taken. If the patient has periarthritis, the joint will appear shrunken and scarred.

Cosmetic concerns: Arthritis may cause small bumps, called nodules, to form on bones. These bumps can occur on any joint, but they are most common in the hands. These nodules may be disfiguring.

Depression: Some arthritis patients may suffer from depression. This may happen if the arthritis interferes significantly with the patient's lifestyle. Patients should consult their healthcare providers if they experience feelings of sadness, low self-esteem, loss of pleasure, apathy, and sometimes, difficulty functioning for two weeks or longer, with no known underlying cause. These may be signs of depression.

Joint damage: In some cases, arthritis can lead to severe joint damage. In such cases, surgery, such as a joint replacement, may be necessary. Patients should regularly visit their healthcare providers to monitor their conditions.

Limited mobility: Patients with arthritis may have limited mobility in their joints. Joint mobility decreases as the joint becomes more damaged. Patients with periarthritis of the shoulder, also called frozen shoulder, may be completely unable to move their joint without aggressive treatment. If arthritis is not properly managed with nonsteroidal anti-inflammatories, arthritis may interfere with a patient's daily life.

Pain: Arthritis may cause severe pain. Patients should stay in close contact with their healthcare providers to ensure that their medications are properly managing the pain. In some cases, the medication or dosage may need to be changed.

Osteoarthritis: The exact cause of osteoarthritis remains unknown. Most researchers believe that several factors, including obesity, age, joint injury or stress, genetics, and muscle weakness, may contribute to the development of osteoarthritis.

Some researchers believe that cartilage damage may occur when cartilage releases too many enzymes that allow for the natural breakdown and regeneration of cartilage. If the body releases too many of these enzymes, the cartilage will be destroyed faster than it can be regenerated. However, it is unknown exactly what causes an imbalance of the cartilage enzyme.

When individuals have osteoarthritis, their bodies try to repair the cartilage damage. However, the body cannot regenerate enough cartilage. Instead, new bone grows alongside the existing bone, causing small lumps to form. Although these lumps cause minimal if any pain, they may be disfiguring and limit the joint's mobility.

Rheumatoid arthritis: The exact cause of rheumatoid arthritis remains unknown. Rheumatoid arthritis is considered an autoimmune disorder because the immune system does not function properly. Normally, the immune system helps the body fight against harmful foreign invaders, such as bacteria, that may cause disease and infection. However, in rheumatoid arthritis patients, the immune system attacks body cells because they are mistaken for harmful invaders.

Patients with rheumatoid arthritis have high levels of white blood cells in the synovial membrane, which line the body's joints. As a result, the joints became painful and swollen. The inflammation causes proteins to be released over months or years, which then results in the thickening of the synovial membranes. This may also lead to damaged bones, cartilage, tendons, and ligaments.

Some researchers believe that this autoimmune process is triggered by an infection with a virus or bacterium. Heredity may also play a role in the development of rheumatoid arthritis.

Periarthritis: Periarthritis typically occurs after the joint becomes injured, which causes scarring, thickening, and shrinkage of the joint. It may also occur after exposure to cold temperatures. Periarthritis typically affects the shoulder.

Individuals who have other types of long-term arthritis that affect the shoulders have an increased risk of developing periarthritis of the shoulder, also called adhesive capsulitis or frozen shoulder.