Q1. What is arthritis?
A1. It is a condition of the musculoskeletal system that causes inflammation of the joints which leads to disability. Arthritis is the most common cause of disability.
Q2. When does it occur?
A2. Arthritis may occur when there is wear and tear of ligaments around a joint. It may be caused when there is wearing away of the cartilage that covers the bone surface or it may be caused due to lack of or inflammation of synovial fluid that nourishes the joint.
Q3. What are the factors that cause arthritis?
A3. It may be caused when there is repetitive movement of the joints as in a physically demanding job, due to infection or previous injury to the joint, due to obesity which puts excessive stress on the joints or it may caused due to genetic factors or family history.
There is increased risk of rheumatoid arthritis, gout and osteoarthritis with age.
Q4. What are the different types of arthritis?
A4. There are several types of arthritis, few common ones are mentioned below:
a) Osteoarthritis: it involves wear and tear of joint cartilage with time. It is seen in ageing population and is hastened by injury or infection. It begins in the cartilage and leads to erosion of the opposing bones. It typically affects weight bearing joints like back, spine and pelvis. Most of the women show some form of osteoarthritis by the age of 60. Obesity and sedentary lifestyle are potential risk factors for development of osteoarthritis.
b) Rheumatoid arthritis: the body's own immune system affects the body tissues. Synovial membrane lining the joint is affected and as the disease progresses the cartilage and bone within the joint are also affected. This results in erosion of the opposing bones. It affects joints of both sides like that of hands, wrists and knees. It is seen on both sides of the body (symmetrical) and leads to severe deformity. There is stiffness especially in the morning and after sitting for long periods. There is development of rheumatoid nodules beneath the skin.
c) Juvenile rheumatoid arthritis: it affects children 16 years of age or younger. It may have genetic predisposition. d) Psoriatic arthritis:it is a chronic inflammatory condition associated with skin disease called psoriasis. There is thickening of the synovial fluid resulting in swollen joints.
e) Ankylosing spondylitis: it is a chronic inflammatory disease that affects the spine and hip joints.
f) Gout: it is inflammatory arthritis that causes sudden severe pain, swelling and tenderness. It is mostly seen in large joint of the big toe and also seen in joints of the feet, ankle, knee, hand, wrist and elbow.
Q5. Which is the most common form of arthritis?
A5. The most common form of arthritis is osteoarthritis which affects the elderly and the next common type is rheumatoid arthritis.
Q6. What are the signs and symptoms?
A6. There is constant pain, swelling and progressive stiffness in the affected joints. This causes difficulty in movement of the affected joint.
Patients also complain of fatigue, weight loss, muscle ache and lack of sleep.
Q7. What are the effects of arthritis?
A7. Arthritic symptoms make movement and exercise difficult and inability to perform functions of daily living leading to reduced physical activity & fitness and this has an overall impact on the patient's quality of life.
Due to decreased physical activity and mobility, there is increased risk of obesity which triggers fear of developing heart diseases.
Becoming home bound may also cause depression in an arthritis patient.
Q8. How is arthritis diagnosed?
A8. Physical examination is conducted to see joint swelling, redness and movement.
Different body fluids like blood, urine and synovial fluid may be tested.
Imaging techniques used are:
- X rays are done to detect bone damage, bone spurs and cartilage loss.
- Ultrasound may be done to detect soft tissue and cartilage. CT scan is done to visualize cross sectional view of bone and surrounding soft tissue.
- MRI may be done to have a detailed cross sectional view of the tendons, ligaments and cartilage.
- Arthroscopy may be done by inserting a small flexible tube called an arthroscope in the joint. It transmits from inside the joint view to a video screen.
Most of the people with rheumatoid arthritis have rheumatoid factor antibody in their blood. More specific blood test for rheumatoid arthritis is cyclic citrulline antibody test. Blood tests will also show increased erythrocyte sedimentation rate and elevated C reactive protein levels. Some people may also have a positive antinuclear antibody test.
Q9. How can it be treated?
A9. The type of treatment depends on person's age, medical history and severity of arthritis. The main goal is to reduce the severity of symptoms and to improve the quality of life.
It may be treated through rest and exercise, medications and physical therapy.
Analgesics are given to relive pain. Non steroidal anti inflammatory drugs are given to reduce both pain and inflammation. Anti rheumatic drugs are given to treat rheumatoid arthritis. Corticosteroids are given to control inflammation and to suppress the immune system.
Surgery may be required in severe arthritis. Damaged joints may be replaced with artificial ones, like in cases of hip and knee joints. Joint fusion may be done for smaller joints of the wrists, ankles and fingers.
Q10. How can arthritis be prevented?
A10. All forms of arthritis are not preventable and arthritis also has genetic predisposition.
However following measures must be taken to have healthy joints:
- Shed excess weight as obesity causes stress on the weight bearing joints.
- Do not have a sedentary lifestyle. You must exercise regularly to keep your joints flexible.
- Follow a healthy lifestyle and take a healthy diet and check your vitamin D levels.
- Avoid injury to your joints by wearing protective gear while playing sports.
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