Arthritis

Arthritis (from Greek arthro-, joint + -itis, inflammation; plural: arthritides) is a group of conditions that affect the health of the bone joints in the body. One in three adult Americans suffers from some form of arthritis, and the disease affects about twice as many women as men.

Arthritic diseases include rheumatoid arthritis and psoriatic arthritis, which are autoimmune diseases; septic arthritis, caused by joint infection; and the more common osteoarthritis, or degenerative joint disease. Arthritis can be caused from strains and injuries from repetitive motion, sports, overexertion and falls. Unlike the autoimmune diseases, osteoarthritis largely affects older people, and results from the degeneration of joint cartilage. Other forms are discussed below.

Arthritic joints can be sensitive to weather changes. The increased sensitivity is thought to be caused by the affected joints developing extra nerve endings in an attempt to protect the joint from further damage.

Signs and Symptoms
All arthritides feature pain, which is generally worse in the morning and on initiating movement but resolves in the course of time. In elderly people and children, the pain may not be the main feature, and the patient simply moves less (elderly) or refuses to use the affected limb (children).

When faced with joint pain, a doctor generally will ask about several other medical symptoms (such as fever, skin symptoms, breathlessness, Raynaud's phenomenon) that may narrow down the differential diagnosis to a few items, for which testing can be done.

Monoarthritis (arthritis of one joint) and fever together are pointers toward septic arthritis (see below). This is a medical emergency and requires urgent referral to an orthopedic surgeon for analysis of joint aspirate and consideration for joint washout.

Diagnosis
The various types of arthritis can be distinguished by the pace of onset, the age and sex of the patient, the amount of (and which) joints affected, additional symptoms such as psoriasis, iridocyclitis, Raynaud's phenomenon, rheumatoid nodules, and other clues.

Blood tests and X-rays of the affected joints often are performed to make the diagnosis. X-rays can show erosions or bone appositions.

Screening blood tests: full blood count, electrolytes, renal function, liver enzymes, calcium, phosphate, protein electrophoresis, C-reactive protein and the erythrocyte sedimentation rate (ESR). Specific tests are the rheumatoid factor, antinuclear factor (ANF), extractable nuclear antigen and specific antibodies whenever the ANF is positive.

Treatment
Treatment options vary depending on the precise condition but include surgery, drug treatment, reduction of joint stress, physical and occupational therapy, and pain management. There also are numerous herbal remedies that purportedly treat arthritis, including Harpagophytum procumbens. For specifics, see the articles on the individual conditions listed below.

Types of Arthritis
Primary forms of arthritis:
 * Septic arthritis
 * Rheumatoid arthritis
 * Osteoarthritis
 * Gout and pseudogout
 * Juvenile arthritis
 * Still's disease
 * Ankylosing spondylitis

Secondary to other diseases:
 * Systemic lupus erythematosus (SLE)
 * Henoch-Schönlein purpura
 * Psoriatic arthritis
 * Reactive arthritis (Reiter's syndrome)
 * Hemochromatosis
 * Hepatitis
 * Wegener's granulomatosis (and many other vasculitis syndromes)
 * Familial Mediterranean fever (FMF), HIDS (hyperimmunoglobulinemia D and periodic fever syndrome) and TRAPS (TNF-alpha receptor associated periodic fever syndrome).

Diseases that can mimic arthritis:
 * Pierre Marie-Bamberger syndrome (hypertrophic pulmonary osteoarthropathy, a paraneoplastic phenomenon of lung cancer)
 * multiple myeloma
 * osteoporosis
 * others

To accurately diagnose the type of arthritis a patient is suffering from, he or she will need to undergo thorough tests by a doctor.

History
While evidence of primary ankle osteoarthritis has been discovered in dinosaurs, the first known traces of human arthritis date back as far as 4500 BC. It was noted in skeletal remains of Native Americans found in Tennessee and parts of what is now Olathe, Kansas. Evidence of arthritis has been found throughout history, from Ötzi, a mummy (circa 3000 BC) found along the border of modern Italy and Austria, to the Egyptian mummies circa 2590 BC. Around 500 BC willow bark gained popularity when it was discovered to help relieve some of the aches and pains of arthritis. It wasn't until more than 2,000 years later, in the early 1820s, that European scientists began to scientifically study the chemical compound in willow bark that alleviated the arthritis symptoms. They discovered the compound was salicin. When they isolated salicin, however, they found it was very noxious to the stomach. Almost 80 years later, in 1897, an employee of Bayer Company -- then a dye production company -- named Felix Hoffman discovered how to isolate the compound and make it less irritating to the stomach. Hoffman was attempting to make the drug in order to help his father, who was suffering from arthritis. In 1899, Bayer Company trademarked Hoffman's discovery under the name "Aspirin." Today it is believed that over a trillion tablets of aspirin have been sold worldwide. .