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Arthritis & Rheumatology


Many people start to feel pain and stiffness in their bodies over time. Sometimes their hands or knees or shoulders get sore and are hard to move and may become swollen. These people may have arthritis. Arthritis may be caused by inflammation of the tissue lining the joints. Some signs of inflammation include redness, heat, pain, and swelling.

What is Arthritis?

There are over 100 disorders that typically affect joints, tendons, ligaments, bones, and muscles and are termed arthritis and rheumatic diseases. Some of these may also involve internal organs.

Forms of arthritis

Examples of arthritis include:

  • Rheumatoid arthritis
  • Osteoarthritis
  • Juvenile idiopathic arthritis
  • Fibromyalgia
  • Gout
  • Systemic lupus erythematosus (lupus)
  • Scleroderma
  • Spondyloarthropathies or ankylosing Spondylosis
  • Infectious arthritis
  • Polymyalgia rheumatic
  • Polymyositis
  • Psoriasis and Psoriatic arthritis
  • Inflammatory arthritis
  • Tendinitis
  • Bursitis

Causes of arthritis

Rheumatic diseases are myriad in their manifestations and causes. While some of these are genetic and a person may be predisposed to getting them or the arthritis may develop a trigger that causes arthritis. This could be an injury or an infection. A cold, flu, or other type of virus could trigger a rheumatic disease in some people. Osteoarthritis may be caused by wear and tear on the joints or by an injury to a joint.

Age and sex play a role in risk of getting arthritis. Some of the conditions are more common among elderly while some including osteoarthritis are more common in women after menopause.

Lupus, rheumatoid arthritis, scleroderma, and fibromyalgia are more common among women. Rheumatoid arthritis occurs two to three times more often in women than in men.

Gout is more common in men than in women. After menopause, the incidence of gout in women begins to rise. This could be due to the hormonal differences or due to genetic differences

In addition, some races and ethnicities are more at risk. Lupus for example is more common in African Americans and Hispanics than in Caucasians.

Diagnosis of arthritis

Rheumatic diseases are diagnosed by regular physicians, orthopedicians as well as specialists in rheumatic diseases or a rheumatologist. Common signs and symptoms include:

  • Pain in one or more joints
  • Swelling in one or more joints. There may be warmth and redness in and around the joint.
  • Stiffness around the joints that lasts for at least 1 hour in the early morning after waking up. This is termed morning stiffness.
  • Constant or recurring pain
  • Difficulty using or moving a joint

Tests for arthritis

Tests commonly include:

  • routine blood tests
  • medical history
  • physical exam
  • X rays
  • imaging studies like CT scans and MRI of joints

Possible treatment

The common treatments that are applicable for most arthritis include rest, relaxation, physical therapy, monitored exercises and joint mobilization, healthy diet, weight loss.

Other therapies include water therapy, health and cold therapy, care for joints, devices such as splints, braces, crutches etc.

Patients may undergo surgery to restore function or to relieve pain and sometimes to introduce prosthetic joint replacements for better mobility. A plan of therapy is developed in conjunction with the patient and a multidisciplinary team.

Drugs are used in many forms of arthritis. The type of drug depends on the condition and on the individual patient. Most of these drugs do not provide a cure but rather limit the symptoms. One of the exceptions is arthritis that is caused by an infection, in which antibiotics can cure the condition.

Commonly used drugs in arthritis include pain relievers that may be applied locally over the skin or taken as pills.  In rheumatoid arthritis, Disease-modifying antirheumatic drugs (DMARDs) and Biologic response modifiers may be tried. Corticosteroids are also used in many rheumatic conditions because they reduce swelling and block or slow down the immune system.

Other drugs used include Hyaluronic acid substitutes, nutritional supplements, enzyme inhibitors like Allopurinol (used in gout) etc.