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Arthritis

17 Apr 2008 8:31 PM - Dr Gordon Bland

The word “arthritis” literally means – inflammation of a joint. Arthritis is characterised by pain, swelling, loss of function, and eventual joint deformity.

Human joints are complex and dynamic structures, and problems with any particular joint will have wider effects, both physical and psychological.

Articular cartilage caps the bony ends at a joint, and a fibrous capsule encloses the joint, holding in the oily joint fluid. The inner side of this capsule is lined by synovium. External to the joint are the muscles and tendons (under a complex neurological feedback control system) and the very important stabilising ligaments.

Broadly speaking, arthritis may be classified into either ‘mechanical' or ‘inflammatory' types.

The classic inflammatory arthritis is rheumatoid arthritis (RA) where multiple joints, usually on matching sides of the body, have very marked inflammation and swelling of the synovium. This deranged synovium becomes extremely damaging to the joint. Interestingly, other body organs (eg. lung, heart and eyes) often become involved with rheumatoid.

The main mechanical arthritis is osteoarthritis (OA) also known as degenerative arthritis. This is, by far, the most common form of arthritis. OA becomes more common as one ages. In contrast to rheumatoid, osteoarthritis has quite limited synovial tissue swelling, but the cartilage is damaged and becomes deficient. OA is not simply “wear and tear” of the bone and cartilage, but a “failure” of the joint repair process. In response to life stresses, all healthy body tissues are constantly repairing themselves (a scratch on your arm will heal itself). So it is with joints. In OA, the repair process is overwhelmed by damage and deterioration, eventually resulting in “joint failure”.

Inflammatory joints will usually be warm, red and swollen, be stiff upon waking, and have increased pain and stiffness following prolonged activity.

Those who develop RA are more likely to be female, have some genetic predisposition, and encounter some sort of a ‘trigger' (perhaps a particular infection).

With mechanical type arthritic joints, there is a relative absence of the warmth, redness and swelling, and there is activity-related pain that improves with rest. The joint may “lock”, “catch”, or “give way”.

Risk factors for developing OA include general factors related to the particular individual (eg. age, sex, genetics, and ethnicity) and local biomechanical factors (eg. overweight, joint overuse/injury, muscle weakness).

Currently, there is no known cure for arthritis, but it can be treated quite effectively. The primary goals of treatment are to educate the patient, control pain, maintain joint function and minimise deformity.

The word “arthritis” literally means – inflammation of a joint. Arthritis is characterised by pain, swelling, loss of function, and eventual joint deformity.

Human joints are complex and dynamic structures, and problems with any particular joint will have wider effects, both physical and psychological.

Articular cartilage caps the bony ends at a joint, and a fibrous capsule encloses the joint, holding in the oily joint fluid. The inner side of this capsule is lined by synovium. External to the joint are the muscles and tendons (under a complex neurological feedback control system) and the very important stabilising ligaments.

Broadly speaking, arthritis may be classified into either ‘mechanical' or ‘inflammatory' types.

The classic inflammatory arthritis is rheumatoid arthritis (RA) where multiple joints, usually on matching sides of the body, have very marked inflammation and swelling of the synovium. This deranged synovium becomes extremely damaging to the joint. Interestingly, other body organs (eg. lung, heart and eyes) often become involved with rheumatoid.

The main mechanical arthritis is osteoarthritis (OA) also known as degenerative arthritis. This is, by far, the most common form of arthritis. OA becomes more common as one ages. In contrast to rheumatoid, osteoarthritis has quite limited synovial tissue swelling, but the cartilage is damaged and becomes deficient. OA is not simply “wear and tear” of the bone and cartilage, but a “failure” of the joint repair process. In response to life stresses, all healthy body tissues are constantly repairing themselves (a scratch on your arm will heal itself). So it is with joints. In OA, the repair process is overwhelmed by damage and deterioration, eventually resulting in “joint failure”.

Inflammatory joints will usually be warm, red and swollen, be stiff upon waking, and have increased pain and stiffness following prolonged activity.

Those who develop RA are more likely to be female, have some genetic predisposition, and encounter some sort of a ‘trigger' (perhaps a particular infection).

With mechanical type arthritic joints, there is a relative absence of the warmth, redness and swelling, and there is activity-related pain that improves with rest. The joint may “lock”, “catch”, or “give way”.

Risk factors for developing OA include general factors related to the particular individual (eg. age, sex, genetics, and ethnicity) and local biomechanical factors (eg. overweight, joint overuse/injury, muscle weakness).

Currently, there is no known cure for arthritis, but it can be treated quite effectively. The primary goals of treatment are to educate the patient, control pain, maintain joint function and minimise deformity.