Arthritis is derived from the terms, ‘arthron’ (joint) and ‘itis’ (inflammation of), meaning inflammation or swelling of one or more joints. There are over 100 different types of arthritis, and symptoms vary depending on the type, but generally includes joint pain and stiffness. Some of the most common ones include:
1. Osteoarthritis (OA): This is the most common type of arthritis, generally referred to as degenerative joint disease or ‘wear and tear’ and predominantly affecting knees, hips and hands. In OA the cartilage that protects the ends of the bones breaks down. This breakdown occurs slowly and gets worse over time. Risk factors include, age, being female (especially after menopause), joint injury, joint overuse, genetics. While the damage in the joints is irreversible, its symptoms can generally be controlled by maintaining a healthy weight, regular physical activity, and with some medications
2. Rheumatoid Arthritis (RA): An autoimmune disease where the body’s immune system attacks its own joints, leading to inflammation, pain, and joint damage. The common affected areas are the joints of fingers, wrists, knees, ankles, toes, feet. This autoimmune inflammation (self-attack), results in damage to the cartilage and joints and deformity can result. The age of onset is commonly between 30-60 years of age, although young-onset rheumatoid arthritis (YORA) can develop in 16-40 year old’s and later-onset rheumatoid arthritis (LORA) occurs in those over 60. The cause of rheumatoid arthritis is not clear, but a combination of genetic and environmental factors and hormones are triggers. In regard to genetic, a person who is HLA-DRB1 positive has a risk of developing rheumatoid arthritis as there is a close associated between HLA-DRB1 and rheumatoid arthritis.
3. Childhood arthritis: Commonly referred as Juvenile Idiopathic Arthritis (JIA) in children under the age of 16. It can result in permanent physical damage to the joints and in severe cases in disability. JIA is idiopathic, meaning the causes are not clear, but the immune system becomes overactive resulting in inflammation around the joints. It is believed that a combination of genetics and environmental factors are involved.
4. Lupus Arthritis: Systemic lupus erythematosus (SLE) is an autoimmune disorder where the immune system targets various organs, including the kidneys, skin, lungs, heart, and joints. Lupus arthritis primarily affects small joints such as those in the hands, wrists, and knees, causing swelling, stiffness, and pain. Unlike OA and RA, lupus arthritis results from systemic autoimmune inflammation rather than degenerative or primarily inflammatory processes. Approximately 95% of people with SLE will experience arthritis during their disease course, highlighting its significant impact and the need for comprehensive management.
5. Psoriatic Arthritis (PsA): PsA is a type of arthritis linked with psoriasis, a skin condition characterised by red, scaly patches. PsA causes joint pain, swelling, stiffness, and skin lesions. It is an autoimmune disorder. The development of PsA is influenced by a combination of genetic factors, environmental triggers, and immune system dysfunction.
6. Gout: Gout is a type of inflammatory arthritis. It affects one joint at a time. It develops when there is a build-up of uric acid in the blood, leading to the formation of sharp, needle-like crystals in the joints. These uric acid crystals cause severe pain, swelling, and redness, often starting in the big toe. Contributors for high uric acid in the blood include diet rich in red meat, organ meats, seafood, excessive alcohol consumption, certain medications, obesity, diabetes, hypertension, kidney disease and genetics.
7. Ankylosing Spondylitis (AS): From the terms, ‘ankylosing’ meaning stiff, and ‘spondylo’ meaning vertebra. This type of inflammatory arthritis which primarily affects the joints and ligaments of the spine, causing pain, stiffness, and limited mobility. AS is an autoimmune disease and there are links with genetic factors such as cells expressing HLA-B27 molecules. Research has progressed in identifying biomarkers in the blood for the early diagnosis of the disease and prediction of progression, advanced imaging techniques, biological therapies to block specific inflammatory pathways.
8. Reactive Arthritis: Also known as Reiter’s syndrome, is a type of arthritis which develops in response to an infection generally originating from the gastrointestinal or genitourinary tracts. It is regarded an autoimmune disorder, leading to joint pain, swelling, inflammation of the urethra, mouth ulcers. Individuals carrying the genetic marker HLA-B27 are at increased risk of developing reactive arthritis.
Management: The management of arthritis typically incudes: Non-steroidal anti-inflammatory drugs, corticosteroids, immunosuppressants, biologic agents, immune modulators, occupational therapy, weight loss, lifestyle modifications such as exercise, rest, and diet, education, and complementary and alternative therapies. It is important to recognise that the field of arthritis is constantly advancing with ongoing research and new discoveries. For the most current information, clinical trial updates, and treatment recommendations, it is advisable to consult trusted sources such as medical journals, professional organisations, and healthcare professionals.
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