Arthritis

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The human body is a very delicate structure, with the bones forming a great part of the shape. The importance of the bone has made it a carrier or support for your body, and this makes your joint to be susceptible to arthritis.
Arthritis  is a disease causing painful inflammation and stiffness of the joints. It  causes pain and inflammation in a joint.. This condition affects people of all ages.
Types of arthritis
The two most common types of arthritis are:
• osteoarthritis

• rheumatoid arthritis.
Both forms damage joints in different ways.

• Osteoarthritis: Osteoarthritis is the most common type of arthritis  affecting around  millions of  people. It most often develops in adults who are in their late 40s or older. It’s also more common in women and people with a family history of the condition. However, it can occur at any age as a result of an injury or be associated with other joint-related conditions, such as gout or rheumatoid arthritis. The most common type of arthritis, osteoarthritis involves wear-and-tear damage to your joint’s cartilage — the hard, slick coating on the ends of bones. Enough damage can result in bone grinding directly on bone, which causes pain and restricted movement. This wear and tear can occur over many years, or it can be hastened by a joint injury or infection. Osteoarthritis initially affects the smooth cartilage lining of the joint. This makes movement more difficult than usual, leading to pain and stiffness. Once the cartilage lining starts to roughen and thin out, the tendons and ligaments have to work harder. This can cause swelling and the formation of bony spurs, called osteophytes. Severe loss of cartilage can lead to bone rubbing on bone, altering the shape of the joint and forcing the bones out of their normal position.
The most commonly affected joints are those in the:
• hands
• spine
• knees
• hips

• Rheumatoid arthritis :  It often starts when a person is between 40 and 50 years old. Women are three times more likely to be affected than men. Rheumatoid and osteoarthritis are two different conditions. Rheumatoid arthritis occurs when the body’s immune system targets affected joints, which leads to pain and swelling.
The outer covering (synovium) of the joint is the first place affected. This can then spread across the joint, leading to further swelling and a change in the joint’s shape. This may cause the bone and cartilage to break down. People with rheumatoid arthritis can also develop problems with other tissues and organs in their body. In rheumatoid arthritis, the body’s immune system attacks the lining of the joint capsule, a tough membrane that encloses all the joint parts. This lining, known as the synovial membrane, becomes inflamed and swollen. The disease process can eventually destroy cartilage and bone within the joint.

Risk factors for arthritis include
• Family history. Some types of arthritis run in families, so you may be more likely to develop arthritis if your parents or siblings have the disorder. Your genes can make you more susceptible to environmental factors that may trigger arthritis.

• Age. The risk of many types of arthritis — including osteoarthritis, rheumatoid arthritis and gout — increases with age.

• Your sex. Women are more likely than are men to develop rheumatoid arthritis, while most of the people who have gout, another type of arthritis, are men.

• Previous joint injury. People who have injured a joint, perhaps while playing a sport, are more likely to eventually develop arthritis in that joint.

• Obesity. Carrying excess pounds puts stress on joints, particularly your knees, hips and spine. Obese people have a higher risk of developing arthritis.

Symptoms
The most common signs and symptoms of arthritis involve the joints. Depending on the type of arthritis you have, your signs and symptoms may vary. The symptoms of arthritis you experience will vary depending on the type you have and this is why it is important to have an accurate diagnosis if you have:
• joint pain, tenderness and stiffness
• inflammation in and around the joints
• restricted movement of the joints
• warm, red skin over the affected joint
• weakness and muscle wasting
• decreased range of motion

Complications
Severe arthritis, particularly if it affects your hands or arms, can make it difficult for you to do daily tasks. Arthritis of weight-bearing joints can keep you from walking comfortably or sitting up straight. In some cases, joints may become twisted and deformed.

Diagnosis
During the physical exam, your doctor will check your joints for swelling, redness and warmth. He or she will also want to see how well you can move your joints. Depending on the type of arthritis suspected, your doctor may suggest some of the following tests.

• Laboratory tests

•The analysis of different types of body fluids can help pinpoint the type of arthritis you may have. Fluids commonly analyzed include blood, urine and joint fluid. To obtain a sample of your joint fluid, your doctor will cleanse and numb the area before inserting a needle in your joint space to withdraw some fluid (aspiration).
•Imaging

•These types of tests can detect problems within your joint that may be causing your symptoms. Examples include:

•X-rays. Using low levels of radiation to visualize bone, X-rays can show cartilage loss, bone damage and bone spurs. X-rays may not reveal early arthritic damage, but they are often used to track progression of the disease.

•Computerized tomography (CT). CT scanners take X-rays from many different angles and combine the information to create cross-sectional views of internal structures. CTs can visualize both bone and the surrounding soft tissues.

•Magnetic resonance imaging (MRI). Combining radio waves with a strong magnetic field, MRI can produce more-detailed cross-sectional images of soft tissues such as cartilage, tendons and ligaments.

•Ultrasound. This technology uses high-frequency sound waves to image soft tissues, cartilage and fluid-containing structures such as bursae. Ultrasound also is used to guide needle placement for joint aspirations and injections.

Treatment of arthritis: There’s no cure for arthritis, but there are many treatments that can help slow down the condition.

Treating  osteoarthritis
Medications are often prescribed, including:
• painkillers

• non-steroidal anti-inflammatory drugs (NSAIDs)
• corticosteroids
In severe cases, the following surgical procedures may be recommended:
• arthroplasty (joint replacement)

• arthodesis (joint fusion)

• osteotomy (where a bone is cut and re-aligned)

Treating rheumatoid arthritis
Treatment for rheumatoid arthritis aims to slow down the condition’s progress and minimise joint inflammation or swelling. This is to try and prevent damage to the joints. Recommended treatments include:

• analgesics (painkillers)
• disease modifying anti-rheumatic drugs (DMARDs) – a combination of treatments is often recommended
• physiotherapy
regular exercise