Generality
An arthritis is any inflammatory condition that involves one or more joints.
There are numerous types (or forms) of arthritis. The causes that induce its appearance can be traumatic, metabolic, infectious, autoimmune or idiopathic.
The most known and widespread forms of arthritis are osteoarthritis and rheumatoid arthritis.
However, we must not forget the existence of gout, psoriatic arthritis, ankylosing spondylitis, cervical spondylosis, systemic lupus erythematosus, enteropathic arthritis, etc.
What is arthritis?
Arthritis is the medical term that indicates the presence of inflammation on one or more joints.
There are different types (or forms ) of arthritis, each with unique causes and characteristics.
Epidemiology
Arthritis is a fairly common inflammatory condition.
According to some statistical studies, in the United Kingdom there are about 10 million people suffering from arthritis, out of a total population of around 64 million inhabitants.
Similar statistical studies, however, reported to the United States, report that the number of Americans with arthritis is about 52 million, out of a total of almost 319 million inhabitants.
A comparison of the two situations shows that the incidence of arthritis in the United Kingdom and the United States is very similar.
Arthritis affects people of any age, including children (juvenile arthritis).
Some epidemiological curiosities:
- In the United States, one in five adults suffers from an established form of arthritis.
- Between 2010 and 2012, in the United States, 49.7% of adults over the age of 65 suffered from an established form of arthritis.
- By 2030, some US experts believe that in the United States, those aged 18 and over with a form of arthritis will be around 67 million.
- In the United States, the number of subjects under the age of 18 with a type of arthritis is approximately equal to 294, 000, or almost one young person every 250.
ANATOMICAL BRIEF RECALL OF A TYPICAL ARTICULATION
The joints are anatomical structures, sometimes complex, which put two or more bones in mutual contact.
In the human body, there are about 360 of them and their task is to keep the various bone segments together, so that the skeleton can fulfill its function of support, mobility and protection.
The anatomists divide the joints into three main categories:
- Fibrous joints (or synarthrosis ), lacking in mobility and whose bones are joined by fibrous tissue. Examples are the bones of the skull.
- Cartilaginous joints (or amphiarthrosis ), with poor mobility and whose bones are linked by cartilage. Classic examples of amphiartrosis are vertebral vertebrae.
- The synovial joints (or diarthrosis ), which thanks to their particular conformation are extremely mobile. Elements such as the articular surfaces (parts of the bones involved in diarthrosis), the joint capsule, the articular cavity, the layer of hyaline cartilage that covers the articular surfaces, the synovial membrane (or synovium) and a series of ligaments contribute to the particular conformation. and tendons.
The most well-known diarthrosis is the knee, shoulder or ankle joints.
Symptoms
To learn more: Arthritis symptoms
Most of the symptoms and signs of arthritis involve the joints of the human body.
The typical manifestations of joint inflammation are:
- Ache
- Joint stiffness
- Joint swelling
- Redness and heat
- Reduced movement capacity
There are forms of arthritis that also involve anatomical non-articular regions, such as the layers of the skin, the eyes, the respiratory system or the lymph-glandular apparatus.
Causes
The causes of arthritis can be traumatic, metabolic, infectious, autoimmune and idiopathic.
The typing of the various existing arthritis depends on the origin of the causes.
Types
There are numerous types of arthritis, some more common than others.
The most known and common forms of arthritis are, without doubt, the so-called osteoarthritis and the so-called rheumatoid arthritis .
Among the less common forms of arthritis, deserve a mention: ankylosing spondylitis, cervical spondylosis, fibromyalgia, systemic lupus erythematosus, gout, psoriatic arthritis, enteropathic arthritis, reactive arthritis, secondary arthritis and polymyalgia rheumatica.
The types of juvenile arthritis, ie the inflammatory conditions of the joints that specifically affect young people, represent a category treated separately.
OSTEOARTHRITIS
Osteoarthritis, also known as osteoarthritis, is the most common type of arthritis ever.
The inflammatory state that characterizes it arises due to the progressive deterioration of the cartilaginous layer that covers the articular surfaces.
Osteoarthritis risk factors are different; among the most important, we note the advanced age, belonging to the female sex, joint injuries and obesity.
Osteoarthritis can affect any joint; however, he has a predilection for the joints of the hand, knees, hips and joints of the spine.
In addition to pain, joint stiffness, swelling and reduced ability to move, it also involves the formation of osteophytes (or bone spurs).
At an advanced stage, osteoarthritis makes it very difficult to use the joints involved in the inflammatory state. For example, if you hit your hands, even a simple task like writing can be complex to do.
Unfortunately, there is no specific cure for osteoarthritis; there are only symptomatic treatments, that is aimed at reducing the symptomatology in progress.
For therapeutic and (for an improvement of the symptoms) and preventive purposes, doctors advise to stay active and practice constant exercise.
RHEUMATOID ARTHRITIS
Rheumatoid arthritis is an autoimmune disease, which is a morbid condition that derives from a malfunction of the immune system .
Different studies have shown that rheumatoid arthritis has several risk factors; among these, the most important are: the genetic-familial predisposition (obviously to rheumatoid arthritis), the belonging to the female sex, the age between 40 and 60 years, the tobacco smoke and the contact with some pathogens (especially herpes virus and Epstein Barr virus).
Unlike osteoarthritis (which attacks articular cartilage), rheumatoid arthritis attacks the joints at the level of the synovial membrane. With a progressive character, the aggression against the synovial membrane induces, in turn, an alteration of the entire articular structure, with articular surfaces and articular cartilage which are damaged, with ligaments weakening and stretching and with the joint capsule that changes shape.
At the beginning of rheumatoid arthritis, inflammation mainly affects the joints of the fingers and toes. At a later stage, it also affects the wrist joints, knees, ankles, hips and shoulder joints.
At the non-articular level, inflammation can involve the skin, the lymph-glandular apparatus, the respiratory system and the eyes.
In addition to the classic symptoms of arthritis, the rheumatoid form can also cause fever, weight loss and muscular hypotrophy.
Often, the condition alternates phases characterized by intense symptoms and phases of apparent remission.
Similarly to the case of osteoarthritis, rheumatoid arthritis is incurable and the only treatments existing against it consist of symptomatic treatments aimed at improving symptoms and slowing down joint degeneration.
ANKYLOSING SPONDYLITIS
Ankylosing spondylitis is a form of chronic and degenerative arthritis, also of autoimmune origin.
This condition mainly determines the fusion of the articular elements of the spine and jeopardizes the good functioning of tendons and ligaments in various parts of the body (especially at the level of the back).
Due to the fusion of the articular elements of the spine, the latter loses flexibility and compromises the patient's postural attitude.
The precise causes of ankylosing spondylitis are still unclear. According to the most accredited causal theories, it would have a genetic origin and a particularly important gene in the development of diseases would be HLA-B27.
At an advanced stage, ankylosing spondylitis also affects other sectors of the human body, including: the eyes (it causes ocular inflammation known as uveitis), the aorta (changes its shape) and the heart (alters the morphology of the valve aortic).
There is no specific cure for ankylosing spondylitis. The only treatments available are symptomatic and are aimed at delaying the onset of complications.
CERVICAL SPONDILOSI
Cervical spondylosis is a degenerative disease that affects the spine, in this case the cervical spine. Dependent on the latter, it determines a form of arthritis that induces the slow but progressive deformation of the vertebral bodies and intervertebral discs.
The precise causes of cervical spondylosis are unknown. However, the researchers agree that the onset of the condition is due to a number of factors, including: a certain genetic-familial predisposition, stress and repeated trauma to the cervical spine, heavy work, strain, hernia removal surgery disc etc.
According to clinical data, cervical spondylosis is particularly widespread in the population over the age of 60; so it is probably a disorder also related to old age.
Lacking a specific cure for cervical spondylosis, the therapeutic goal of the treatments available today is to improve symptoms (reduce pain, prevent permanent spinal injuries, etc.).
SYSTEMIC LUPUS ERYTHEMATOSUS
Systemic lupus erythematosus ( SLE ) is a chronic inflammatory disease of autoimmune and multisystemic origin.
Multisystemic means that it affects different organs and tissues of the body. These tissues also include the anatomical structures that make up the joints.
Although they have not yet identified the precise causes, researchers are of the opinion that SLE appears due to a combination of genetic, hormonal and environmental factors.
To learn about systemic lupus erythematosus therapy, readers can click here.
GOUT
Gout is a metabolic disease that causes:
- Elevated serum urate levels (hyperuricemia)
- Formation of uric acid deposits at various sites in the human body (tophi)
- Inflammatory states affecting the joints, with deposits of urates in the cartilages (gouty arthritis)
- Kidney disease
Definitely more widespread in males, gout causes intermittent pain, swelling, erythema and heat in the joints.
The most affected joints are those of the hands and feet: in absolute terms, the most affected site is the metatarsal-phalangeal joint of the big toe.
Gout is treatable: there are treatments for both gout attacks and to prevent future attacks.
To learn more about gout therapy, readers can consult the article here.
FIBROMYALGIA
Fibromyalgia is a rheumatic condition that affects the musculoskeletal system.
As you can guess from its name, it causes pain in the muscles and fibrous tissues, which in the specific case are tendons and articular ligaments.
In terms of symptoms, fibromyalgia determines:
- A chronic and widespread painful sensation
- Increased muscle tension
- Rigidity in numerous locations of the locomotor system
The precise causes of fibromyalgia are unclear; at the moment, doctors suspect that this condition has a multifactorial origin (genetic, neurochemical, environmental, hormonal, psychological factors, etc.).
Currently, fibromyalgia is treatable only in symptoms.
ENTEROPATHIC ARTHRITIS
Enteropathic arthritis is a type of chronic arthritis, typically associated with two chronic inflammatory bowel diseases: Crohn's disease and ulcerative colitis (or ulcerative rectocolitis).
It mainly affects the joints of the extremities of the human body and the joints of the spine.
The causes of enteropathic arthritis are still unclear. According to the researchers, in some cases the genetic-familial predisposition plays a decisive role.
Currently, enteropathic arthritis is treatable only in symptoms.
REACTIVE ARTHRITIS
Reactive arthritis is a type of dual origin arthritis: infectious and autoimmune.
Based on various scientific studies, the microorganisms involved in the development of this joint inflammation would be: chlamydia, salmonella, shigella, yersinia and campylobacter, all bacterial pathogens.
In addition to the joints, reactive arthritis can also affect the eyes and the urethra, causing conjunctivitis and urethritis, respectively.
When reactive arthritis also affects the eyes and urethra, it gets the more correct name of Reiter 's syndrome . Palliative drugs are available for treatment.
RHEUMATIC POLYMALAGIA
Polymyalgia rheumatica is an inflammation of the muscles, which starts at the shoulders, neck and hips, and then spreads to the rest of the body and also affects the joints.
After all, muscles and joints are interconnected and, very often, the state of health of the former depends on the health of the latter.
The causes of polymyalgia rheumatica are currently unknown; according to the most reliable hypotheses, at the origin of the condition there would be a combination of genetic and environmental factors.
The main treatment for polymyalgia rheumatica is the administration of corticosteroids, very powerful and effective anti-inflammatory drugs, but also with numerous side effects.
PSORIASIC ARTHRITIS
Psoriatic arthritis is a type of arthritis that develop people with a medical condition known as psoriasis .
Psoriasis is a chronic, recurrent inflammatory disease of the skin, which is not contagious, which occurs as a result of hyperproliferation of epidermal keratinocytes and causes the formation of reddish patches / plaques especially on the knees, elbows, hands, scalp and feet.
Psoriatic arthritis - like psoriasis - is very likely to have an autoimmune origin.
It can affect any joint in the human body; however, it mainly affects the articular elements of the hands, feet, knees, elbows, neck and spine.
SECONDARY ARTHRITIS
Secondary arthritis is a type of arthritis that occurs as a result of a repeated injury to a joint or a pair of joints (for example, the two knees, the two shoulders, etc.).
Generally, it appears after several years of injury.
YOUTH FORMS
The most important forms of juvenile arthritis fall under the great category known as juvenile idiopathic arthritis ( JIA ).
In medicine, the term idiopathic / idiopathic, associated with the name of a pathology, indicates that the latter has arisen for unknown or unidentifiable reasons.
Returning to the forms of juvenile AJ arthritis, these conditions are:
- Juvenile oligoarticular arthritis (or oligoarthritis or oligoarticular AIG ): it is the most common form of AIG and affects less than 5 joints. In most cases, the joint elements involved are the knees, ankles and wrists.
Prognosis is generally good and long-term effects are rare. However, it should be noted that some patients also develop eye problems.
- Polyarticular AIG : this form of juvenile arthritis affects more than 5 joints and resembles, in terms of symptoms, rheumatoid arthritis.
Often, on the onset of polyarticular AIG they follow the appearance of skin rash and fever.
- Systemic JIA : this juvenile arthritis determines, initially, fever, skin rash and lethargy; only later, joint problems arise (swelling, pain, etc.).
- AIG associated with enthesitis (or arthritis with enthesitis ): it is a form of juvenile arthritis that causes pain in the feet, knees and hips.
