What is Arthritis?
 The word “arthritis” is derived from two Greek words: arthron, meaning a joint, and –itis which means inflammation. Inflammation typically involves redness, heat, swelling, tenderness and loss of function. So, technically speaking, arthritis simply describes a joint that is red, hot, swollen, tender and that is functionally impaired.
However, in common use, arthritis usually means any of a number of chronic conditions in which your joints are painful and stiff. If your joints are actually red, hot, swollen, and tender, this is often described as inflammatory arthritis.
A related term, used less often by doctors now, is rheumatism. This nonspecific term refers to any persistent condition of pain and stiffness related to joints, tendons, ligaments, or bursas. Bursas are small ‘cushions' that lie under a tendon to protect it from friction and injury.
What causes arthritis?
Arthritis is not one disease with one cause. There are different types of arthritis, each with its own cause. For instance, bacteria can sometimes cause a severe acute infection called infectious arthritis. Men with hemophilia can have bleeding inside their joints (hemarthrosis), which over the years can cause a severe arthritis. One particularly severe and sudden type of arthritis, gout, is caused by crystals of a chemical called uric acid being deposited inside a joint (typically at the base of the big toe - podagra).
Rheumatoid arthritis is a specific form of inflammatory arthritis that will be discussed in detail in the next section. It results because your own immune system starts (for no known reason) to attack the delicate membrane lining the inside of your joints. Because rheumatoid arthritis is caused by your body attacking itself, it is referred to as an autoimmune disease.
The other type of arthritis that will be discussed later in this article is osteoarthritis. This, the most common type of arthritis, is caused by wear-and-tear on the joints. Because of this, some doctors refer to osteoarthritis as age-related degenerative joint disease. In the past it used to be called osteoarthrosis.
Rheumatoid arthritis
Who gets rheumatoid arthritis?
Rheumatoid arthritis affects about one or two percent of adults, usually starting between the ages of 20 and 40. Three quarters of all cases are in women.
What are the symptoms of rheumatoid arthritis?
Because rheumatoid arthritis involves significant inflammation, it can often give you symptoms such as fever, weight loss and malaise, especially at the beginning of the illness. Your small joints are usually the most affected, such as the middle joints of the fingers, the wrists, the jaw joint, the toes and ankles. In rheumatoid arthritis, your joints are usually very inflamed – red, hot, swollen, and painful. Stiffness is usually worst in the morning, so many people will talk about morning stiffness. With time, rheumatoid arthritis can cause significant crippling and deformity of the joints.
How is rheumatoid arthritis diagnosed?
The diagnosis of rheumatoid arthritis is an important one to make, so careful testing is necessary. Your doctor will almost always do X-rays of your painful joints – although the X-rays may be normal initially, they will usually show damage to the joints with time. Blood tests can be very useful. Tests called erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) indicate how much inflammation is going on. A test called the rheumatoid factor measures the presence and level of rheumatoid factor in the blood; this factor is found in 75% of people with rheumatoid arthritis, and high levels often indicate severe disease.
How is rheumatoid arthritis treated?
Rheumatoid arthritis is a serious chronic disease that can cause crippling and reduce life span – optimal treatment is necessary. Apart from drugs, other treatment options include physiotherapy, rest, gentle exercise, splints, and other devices.
 bacterial infection Most patients with rheumatoid arthritis will be treated initially with anti-inflammatory drugs. These drugs reduce pain and swelling, reduce the duration of morning stiffness, and generally reduce the symptoms. The most recent type of anti-inflammatory medications are called COX-2 inhibitors. COX or cyclooxygenase is an enzyme that acts on arachidonic acid, produced as a result of another enzyme phospholipase A 2 , acting on phospholipids released from cell membranes as a result of cell injury, COX, in turn, by acting on arachidonic acid results in formation of prostaglandins and thromboxanes, mediators of inflammation. However, inflammation is not always harmful. In fact it is a fundamentally protective but potentially harmful response. COX exists in two forms -COX-1 and COX-2. COX-2 is induced (synthesis increases) by inflammation while COX-1 is routinely produced and has useful actions on gastro-intestinal tract and kidney function.
Because anti-inflammatory drugs only treat the symptoms of rheumatoid arthritis (they do not prevent the crippling that occurs over time), emphasis is now placed on what are called disease-modifying antirheumatic drugs (DMARDs). These medications can actually reduce the chance of crippling deformities and reduce the rate of other complications.
 Osteoarthritis
Who gets osteoarthritis?
Osteoarthritis is the most common type of arthritis. Just about everybody who lives long enough will get osteoarthritis – even at age 40, 90% of people have signs of wear-and-tear on their joints.
What are the symptoms of osteoarthritis?
Osteoarthritis is not a dramatic condition. It starts gradually, and gets worse over years. Because it is caused by wear-and-tear, it tends to affect your big weight-bearing joints (hips and knees), as well as your finger joints (usually the knuckle closest to the end of the finger). Inflammation is not a factor, so the joints are typically not red or hot or tender. Swelling may occur over time.
How is osteoarthritis diagnosed?
There is little urgency involved in diagnosing osteoarthritis, so tests are often unnecessary – typical symptoms, in an older person, can usually make the diagnosis. Many doctors will suggest X-rays of the affected joints if you are younger or if symptoms are more severe. Blood tests are seldom done, unless your doctor feels that you might have a different type of arthritis such as rheumatoid arthritis.
How is osteoarthritis treated?
Osteoarthritis is often a mild problem, so you will not need any specific treatment. Gentle exercise is always a good idea, as is heat. If your hands are affected by osteoarthritis, you might want to volunteer to wash the dishes after dinner in pleasantly hot water! For mild pain or stiffness, simple pain-relieving drugs are effective. If your symptoms are more troublesome, your doctor will probably prescribe an anti-inflammatory drug.
If you have severe osteoarthritis of the knees or hips that is limiting your activities, you may be a candidate for surgery. Replacing your arthritic hip or knee with a new synthetic one made of titanium, other metals, and plastics, can make a huge difference in pain and mobility.
See Your Doctor!
If you have joints that are persistently painful, stiff or swollen, see your doctor to get an accurate diagnosis and optimal treatment. With appropriate advice and treatment your pain and stiffness can be helped.
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