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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.

Gouty Arthritis

An attack of gout is caused due to deposition of uric acid in the joints. This occurs due to overproduction of uric acid or inability of the kidneys to flush out the uric acid. Gouty arthritis is characterized by pain in the joints of the feet and hands. Persons suffering from diabetes, obesity or kidney disease are also likely to suffer from gouty arthritis. Those taking drugs that interfere with uric acid excretion such as thiazide diuretics, pyrazinamide and ethambutol may develop gouty arthritis. Gout can sometimes be a hereditary condition. The excessive uric acid crystals are deposited within the joint space causing irritation and swelling. Typically persons suffering from gouty arthritis experience pain in the base of the toes. The ankles and knees are also likely to get affected. An attack of gouty arthritis differs from other arthritis conditions in that it affects one joint at a time.

Gouty arthritis attacks are painful and can recur at irregular intervals. The condition can then become chronic. The affected joint becomes red, swollen and extremely tender. Repeated attacks of gouty arthritis might lead to joint deformity and limited motion. A condition of chronic kidney failure might also result. is done and the fluid is examined for presence of uric acid crystals. Blood and urine tests reveal the levels of uric acid. A person suffering from acute attacks must maintain adequate fluid intake to reduce . A purine-rich diet can aggravate gout attacks. Reduced dietary fat and calorie intake is always beneficial. Excessive alcohol consumption can trigger disorder of uric acid metabolism.

Person suffering from gouty arthritis can relieve symptoms by resting and elevating the affected joint. Use of ice packs can help in reducing inflammation and pain. Uric acid levels in the blood are usually treated with Probenecid (Benemid) and sulfinpyrazone (Anturane). The medications aid the excretion of uric acid into the urine. Powerful corticosteroids are prescribed in short courses for treating acute cases of gout.


Osteoarthritis

Also known as degenerative joint disease or wear and tear arthritis, osteoarthritis is the most prevalent type of arthritis. The cartilage (a protein substance present in all joints, this substance serves as a cushion in between the bones) in the joints deteriorates over time thus leading to osteoarthritis. Generally women are more at risk of osteoarthritis when compared to men.

Osteoarthritis can affect any joint in the body but it largely affects the joints of the hips, feet, knees, spine and hands. The weight bearing joints get affected the most due to osteoarthritis. Usually a single joint is affected due to osteoarthritis but if osteoarthritis sets in the finger joints, it can affect more than one joint at the same time.


Causes for osteoarthritis

Protein content of the cartilage drops and water content increases with age. This will degenerate the cartilage thus causing osteoarthritis. Increased mechanical stress on the joints due to obesity can cause osteoarthritis. The knee joint, in particular, unable to take the excess weight will degenerate thus leading to osteoarthritis. People who are born with abnormally shaped joints risk osteoarthritis as their joints are put to undue stress thus causing early deterioration. Any external injury can cause degeneration of the joints thus leading to osteoarthritis. In rare cases heredity can be a cause for osteoporosis.


Symptoms of osteoarthritis

Symptoms for osteoarthritis vary from person to person depending on the severity of the problem. The most commonly prevalent symptoms for osteoarthritis are:

  • Tenderness/softness of the joints even when light pressure is applied to the joint.
  • Creaking/annoying feeling in the joint.
  • Warmth in the joint.
  • Fluid retention in few cases.
  • Pain in the joint while using the joint, after use of the joint or after a prolonged period of rest of the joint.
  • Bone spurs in the form of lumps occur in the joint.
  • Reduced flexibility of the joint.
  • Swelling of the affected joint.
  • Stiffness of the joint, particularly in the mornings while you get out of the bed and after a prolonged period of rest.

Diagnosis of osteoarthritis

An x-ray can reveal the extent to which the joint is affected, be it bone spurs and narrowing of the joints. Arthroscopy and Arthrocentesis may be done. Fluid from the joint is drawn using a long sterile needle. This fluid is analyzed for determining the cause for the pain.


Treatment for osteoarthritis

Rest can help the joints recover to a great extent. Reducing weight can help relieve the strain on the joints thus reducing pain. Applying heat and cold packs alternately on the affected joint can relieve pain to a certain extent. Physical therapy can strengthen the muscles around the joints thus reducing the pain. Physical therapy also improves the mobility of the joint. Exercises can help relieve pain; but ensure that you are under supervision by a trained person. Support device like splints, braces, walkers, canes etc can offer extra support for the affected joint. For patients suffering from acute osteoarthritis, surgery is the final respite. Surgery is particularly helpful for patients who have not responded to any of the above mentioned treatments.

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Collection of Pages - Last revised Date: November 11, 2019