Arthritis
The smooth cartilage layer that lines a joint is lost, resulting in bone grinding on bone during movement. This mechanical failure defines arthritis as a general medical term for a specific type of joint disorder. Symptoms generally include joint pain and stiffness alongside redness, warmth, swelling, and decreased range of motion. In certain types of arthritis, other organs such as the skin are also affected. Onset can be gradual or sudden depending on the underlying cause. The word itself derives from arthr- meaning joint and -itis meaning inflammation.
Osteoarthritis occurs most commonly in weightbearing joints like hips, knees, shoulders, and fingers as a person ages. Rheumatoid arthritis is an autoimmune disorder that often affects hands and feet by attacking the lining of the joint capsule. Gout forms when excessive uric acid production results in urate crystals depositing in joints particularly toes. Lupus presents as an autoimmune collagen vascular disorder where about 90% of patients have musculoskeletal involvement. Septic arthritis typically occurs when bacteria spread through the bloodstream to erode cartilage rapidly.
Pain in varying severity is a common symptom in most types of arthritis along with swelling and joint stiffness. Other symptoms include inability to use the hand or walk, rash, itch, malaise, fatigue, weight loss, poor sleep, muscle aches, tenderness, and difficulty moving the joint. Some common risk factors for osteoarthritis include obesity, prior injury to the joint, type of joint, and muscle strength. The strongest associations for inflammatory arthritis are female sex, family history, age, obesity, previous joint damage, and exposure to tobacco smoke. Smoking has been linked to increased susceptibility of developing rheumatoid arthritis specifically.
Diagnosis is made by clinical examination from an appropriate health professional supported by radiologic imaging and blood tests depending on suspected type. Rheumatoid arthritis is generally worse in the morning associated with stiffness lasting over 30 minutes while osteoarthritis pain tends to be related to activity initially then becomes constant. Physical examination may include observing affected joints evaluating gait and examining skin for findings related to rheumatological disease. Screening blood tests include rheumatoid factor antinuclear factor extractable nuclear antigen and specific antibodies. Patients often have elevated erythrocyte sedimentation rate or C-reactive protein levels indicating inflammation. X-rays show narrowed joint space bone spurs sclerosis and bone cysts consistent with osteoarthritis.
There is no known cure for arthritis and rheumatic diseases so treatment options vary depending on the type. Treatment typically begins with medications having fewest side effects with further additions if insufficiently effective. First-line treatment for osteoarthritis is acetaminphen while inflammatory arthritis involves non-steroidal anti-inflammatory drugs like ibuprofen. Joint replacement surgery known as arthroplasty has been incorporated since the 1950s to repair damage restore function or relieve pain. Common joints replaced due to arthritis include shoulder hip and knee. Arthroscopic surgery for osteoarthritis of the knee provides no additional benefit compared to optimized physical and medical therapy. Joint replacement surgery can last anywhere from 15 to 30 years depending on patient factors.
In the United States a CDC survey based on data from 2013 to 2015 showed 54.4 million adults had self-reported doctor-diagnosed arthritis. This represents 22.7% of adults while 23.7 million had arthritis-attributable activity limitation. Disability due to musculoskeletal disorders increased by 45% from 1990 to 2010 making osteoarthritis the fastest increasing major health condition. The total cost of arthritis cases is close to $100 billion of which almost 50% comes from lost earnings. In Australia about 15% of people are affected while in the United States more than 20% have a type of arthritis. Data from Africa are lacking and underestimated with studies showing varying prevalence rates across different regions like South Africa and Egypt.
The first known traces of human arthritis date back as far as 4500 BC found in skeletal remains of Native Americans in Tennessee and Olathe Kansas. Evidence has been discovered throughout history from Ötzi mummy found along border of modern Italy and Austria to Egyptian mummies. In 1715 William Musgrave published his medical work De arthritide symptomatica concerning arthritis and its effects. Augustin Jacob Landré-Beauvais was the first person to describe symptoms of rheumatoid arthritis though his classification as relative of gout was inaccurate. John Charnley completed the first hip replacement in England to treat arthritis during the 1960s establishing modern surgical standards for joint disorders.
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Common questions
What is arthritis and how does it affect joints?
Arthritis is a general medical term for a specific type of joint disorder where the smooth cartilage layer that lines a joint is lost. This mechanical failure results in bone grinding on bone during movement.
How do symptoms differ between osteoarthritis and rheumatoid arthritis?
Osteoarthritis pain tends to be related to activity initially then becomes constant while rheumatoid arthritis is generally worse in the morning associated with stiffness lasting over 30 minutes. Other symptoms include swelling, redness, warmth, decreased range of motion, and fatigue.
When was the first hip replacement surgery performed to treat arthritis?
John Charnley completed the first hip replacement in England to treat arthritis during the 1960s establishing modern surgical standards for joint disorders. Joint replacement surgery known as arthroplasty has been incorporated since the 1950s to repair damage restore function or relieve pain.
Who discovered early evidence of human arthritis dating back to ancient times?
The first known traces of human arthritis date back as far as 4500 BC found in skeletal remains of Native Americans in Tennessee and Olathe Kansas. Evidence has been discovered throughout history from Ötzi mummy found along border of modern Italy and Austria to Egyptian mummies.
What percentage of adults in the United States had self-reported doctor-diagnosed arthritis between 2013 and 2015?
A CDC survey based on data from 2013 to 2015 showed 54.4 million adults had self-reported doctor-diagnosed arthritis representing 22.7% of adults. Disability due to musculoskeletal disorders increased by 45% from 1990 to 2010 making osteoarthritis the fastest increasing major health condition.