Septic Arthritis

Septic Arthritis is also known as bacterial arthritis and is a condition caused by bacterial infection of the joint space. The infection may be located at the affected joint or may have traveled through the bloodstream. Micro-organisms such as Staphylococcus aureus, Streptococcus pneumoniae, and group B streptococci are often the cause for this form of arthritis. This medical condition must be treated immediately lest it destroy the affected joint. The knees and hip are most often affected by septic arthritis. But sometimes the shoulder, wrist, elbow or ankles are affected. Often septic arthritis is noticed in persons who have had traumatic injury to the joint or fitted with an artificial joint. Diabetes and rheumatoid arthritis can put a person at higher risk for septic arthritis. Poor immune system and intravenous drug abuse are other conditions that put a person at additional risk of contracting septic arthritis. Septic arthritis manifests with symptoms such as intense joint pain and swelling of the affected joint. Swelling on the affected joint makes it very tender and redness is noticed. Low grade fever is also noticed.

Aspiration of synovial fluid and its culture helps in diagnosing septic arthritis. X-rays may not help in detecting this form of arthritis in the early stages. Draining the increased synovial fluid from the affected joint can help in relieving pressure and reduce symptoms of septic arthritis. The damage to the affected joint can be arrested once the fluid is drained. Blood tests can help in prescribing the right antibiotics to find the type of bacteria that is causing the infection. In the early stages of treatment, the antibiotics are directly injected into the vein. But the antibiotic treatment must be continued till the infection is completely eliminated. While warm compresses and elevation gives some relief to a person suffering from septic arthritis, rest will also do good. The affected joint may be rehabilitated with supportive exercises.

Juvenile arthritis

Any form of arthritis occurring in children below the age of 16 years is called juvenile or childhood arthritis. It is a chronic auto immune disease, where the body attacks its own healthy cells. There are three main types of juvenile arthritis - juvenile rheumatoid arthritis (JRA), juvenile chronic arthritis and juvenile idiopathic arthritis (JIA). But juvenile rheumatoid arthritis is the most common form of arthritis.

Symptoms of juvenile arthritis

Juvenile Arthritis - JA is mostly an autoimmune disorder. It can sometimes result from an auto inflammatory disorder.

Swelling, pain and stiffness in the joints.

Limited motion and loss of flexibility.

Damage to joint and cartilage.

Short stature due to deformed growth of bones.

Polyarthritis is involvement of multiple joints, usually five or more joints. Usually smaller joints of the hand but sometimes even larger joints like hip, neck, shoulder, jaw, etc are affected. Oligo articular arthritis is involvement of less than 4 joints and usually involves larger joints. Limitation of moment, pain and swelling are some of the symptoms seen, along with fever which is high and spiking often lasting for several weeks or months with pale red spots on the chest, thighs or other parts. When the joints get inflamed and stiff, growth is impaired or distorted. Eye inflammation is also noticed.

Treatment is important for juvenile arthritis, as proper leg exercises can help reduce the pain and discomfort. Early diagnosis and appropriate treatment, along with medication and physiotherapy is of utmost benefit. NSAIDs and Corticosteroids are prescribed. Disease-modifying antirheumatic drugs (DMARDs) also provide relief from symptoms but take many weeks to slow the progression of the JA.

Rheumatoid Arthritis

Painful, stiff joints are the primary symptoms of rheumatoid arthritis. Rheumatoid arthritis is an autoimmune disease resulting in chronic inflammation of the joints. More than one joint is usually affected. Women are more predisposed to contracting rheumatoid arthritis. It usually sets in when a person is between 40 - 60 years. The exact reason for the autoimmune system attack is not known. This condition is hereditary and can be brought about by environmental and hormonal factors. Tissues around the joint become inflamed in a rheumatoid arthritic condition. During an attack of rheumatoid arthritis, symptoms such as fatigue, lack of appetite, low grade fever and joint stiffness are noticed. The symptoms are most notable in the morning or after long periods of inactivity. These attacks come and go.

Rheumatoid arthritis is a progressive disease that can lead to joint destruction and functional disability. Multiple joints including small joints of the hands and wrist are often affected. Rheumatoid arthritis can be extremely debilitating, thereby making simple chores painful. In fact, rheumatoid arthritis can even affect the salivary glands, tear glands and heart and lungs.

A rheumatologist will diagnose the condition based on blood test, x-rays and physical examination. The joints are examined for inflammation and deformity and presence of rheumatoid nodules. In persons suffering from rheumatoid arthritis, blood antibodies such as citrulline are noticed. Arthrocentesis or extraction of joint fluid is also conducted. There is no known cure for rheumatoid arthritis. Medication is prescribed to relieve joint inflammation and prevention deformation of the joints. First-line drugs like corticosteroids or aspirin are used to reduce pain and inflammation whereas second-line drugs such as methotrexate and hydroxychloroquine are prescribed for preventing progressive joint destruction. An exercise regimen may need to be followed for preventing work disability and strengthening the joints.