Inflammatory Arthritis
What are the causes of the serious condition known as inflammatory arthritis? What can be done to treat them?
Welcome to my third article about arthritis. My first two covered osteoarthritis– and ; this article will focus on the more serious kind of arthritis know as inflammatory arthritis.
What Is Inflammatory Arthritis?
So what makes inflammatory arthritis more serious than osteoarthritis? The key is the word inflammatory, which comes from Latin root words meaning “into flames.” Inflammation in the body involves swelling, as well as many of the features of flames: heat, redness, and pain. So the more the inflammation, the more the joints get swollen, and are painful.
There three main types of inflammatory arthritis:
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Infectious arthritis
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Arthritis caused by crystals
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Autoimmune arthritis.
What Is Infectious Arthritis?
A joint infected by bacteria is a serious problem. If not treated quickly, infectious arthritis can cause permanent damage to the joint or spread to other parts of the body.
The most common symptom of this type of arthritis is a single joint that becomes swollen, red, and painful fairly rapidly. Children are especially prone to getting an infected joint, particularly in the legs. The infection most commonly comes from the bloodstream with no clear provocation. Since it’s a serious problem, any child with a limp not associated with a known injury and that lasts more than 30 minutes should be evaluated by a doctor. This symptom is more difficult to identify in infants under a year of age because they often aren’t walking yet, and the symptoms are subtle; fever and irritability are the main symptoms, accompanied by increased crying with the movement of the affected limb. Problems like this are part of what makes pediatrics a challenge, but fortunately it’s fairly uncommon.
Adults can get infectious arthritis as well. Younger, healthier people usually get it as a result of a cut or animal bite that penetrates the joint, although sexually active young adults can get it from gonorrhea, a sexually transmitted bacteria infection, that can spread to multiple joints. Elderly people with weakened immune systems will get infected joints from the bloodstream, and artificial joints are also prone to infection.
What Is Crystalline Arthritis or Gout?
Crystal arthritis is actually more common than infectious arthritis. No, it’s not the kind that happens to new age people who do too much channeling; the most common crystalline arthritis is one that bears the unfortunate name, gout. Gout is caused when uric acid, a waste-product found in the bloodstream, builds up in the blood and crystalizes in a joint. Oddly, the most common joint affected by gout is the one at the base of the big toe, although gout can also occur in the knees, ankles, and joints of the arms as well. The key to identifying gout is that it is extremely painful and comes on fairly suddenly. It often looks like an infectious arthritis, but the location and the health of the individual can be clues that gout is the cause, not infection.
What Causes Gout?
So what causes the build up of uric acid that can lead to gout? Some people don’t break down uric acid properly, so they build up levels in their blood. Certain foods, like liver, kidney, and sardines (nothing you will find me eating) contain a certain chemical that is broken down to uric acid, so eating these foods can raise the levels as well. Finally, certain medications and blood conditions can also make the levels go up, predisposing the person to crystal formation in a joint. Why does it happen in the big toe? I really don’t know, but the fact that it does often makes gout easy to diagnose. If the diagnosis isn’t clear, then fluid from the joint can be removed and analyzed for crystals or signs of infection.
How Is Gout Treated?
Gout can be treated with medications that reduce inflammation in the joint, and there are also medications to lower the levels of uric acid. Obviously, people with gout should avoid eating sardines and other foods that raise uric acid levels, and they shouldn’t take certain medications. Your doctor can give you more details on this.
What Is Autoimmune Arthritis?
The last kind of inflammatory arthritis I am going to cover is known as autoimmune arthritis. Autoimmune problems are conditions where parts of the body are attacked by the immune system, which causes harm to those body parts attacked. There are a number of autoimmune diseases that attack the joints, the most common of which are rheumatoid arthritis and juvenile rheumatoid arthritis. I’ll cover other autoimmune diseases like lupus in a future article.
What Is Rhematoid Arthritis?
In rheumatoid arthritis, joints are swollen and painful, and multiple joints throughout the body are often affected. Typically there is the presence of an antibody against the cartilage in the joints, which is known as rheumatoid factor, although some cases of RA happen without it. It was initially thought that the rheumatoid factor was the cause of RA, but now it isn’t so clear. It is, however, believed that the immune system is involved, as drugs that blunt the immune response can improve symptoms significantly. The onset of RA is generally gradual, and it more frequently affects the joints further away from the trunk, with the hands and feet bearing the brunt of the pain and swelling. There are cases where RA starts in a single joint, and cases where it starts in other parts of the body like the lungs, but the majority of the time its main focus is in the arms and legs.
What Are the Symptoms of Rheumatoid Arthritis?
The main early symptom of RA is stiffness lasting over one hour in the morning. The swelling of certain joints, such as the knuckles at the base of the fingers and the wrist, and swelling in a symmetrical pattern are also strongly suggestive of RA. The course RA takes in a person can vary widely, from a slowly progressive, milder disease, to a rapidly progressive and severe arthritis. If left untreated, it can cause crippling deformity and pain.
How is Rheumatoid Arthritis Treated?
In the past, there wasn’t much that could be done about RA, and what could be done had significant side effects. But recently things have changed dramatically, with the development of very effective medications that can significantly reduce symptoms and slow the progression of the disease. This is probably the most important message I can give about RA: don’t leave it be. Get treatment, and not just with the short term medications like prednisone or anti-inflammatory drugs, but with the newer medications. Go to a rheumatologist. It could greatly reduce your pain and disability in the future.
What Is Juvenile Rheumatoid Arthritis?
Finally, I want to mention a few things about juvenile rheumatoid arthritis, or JRA. The first thing is that JRA is a totally different disease than RA, obviously affecting children much more than adults, but also having much different patterns of joints it affects. Unfortunately, it’s a much harder disease to treat than RA, although a lot of research is being done on finding effective treatments. Again, the best advice I can give is to make sure your child goes to see a doctor who specializes in that type of disease. Aggressive treatments for these terrible diseases can greatly improve the long-term outcome.
That’s all for this podcast. Next week I’m going to move on from arthritis and go to a terrible illness that has made a recent comeback and is killing children.
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Let me once again remind you that this podcast is for informational purposes only. My goal is to add to your medical knowledge and translate some of the weird medical stuff you hear, so when you do go to your doctor, your visits will be more fruitful. I don’t intend to replace your doctor; he or she is the one you should always consult about your own medical condition.
Catch you next time! Stay Healthy!
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