Arthritis / Joint inflammation 4.51/5 (39)

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Joint pain

Arthritis - arthritis causes stiffness and pain in joints

Arthritis - arthritis, "synovitis"

Definition

Arthritis is inflammation of one or more joints (mono- and polyarthritis, respectively), either large joints (knees, hips, shoulders, elbows) or small joints (fingers, toes, jaw joints)

  • "Synovitis" actually describes the rheumatic inflammation that can be seen by tissue sample (biopsy) from the inside of an arthritis joint. In practice, the word "synovitis" is also used for joint inflammation / arthritis
  • In Norwegian, we separate "arthritis" from Osteoarthrtitis (English: osteo-arthritis)
    • Osteoarthritis has less inflammation than arthritis
  • Most forms of arthritis are caused by a autoimmune attack from our own immune system. The triggering cause is most often unknown
  • Septic (infectious) arthritis is caused by infection, most often bacteria
joint pain, arthralgia

Illustration: Joint pain in arthritis: Pixabay

Symptoms of arthritis - inflamed joints

Arthritic Diseases (Arthritis)

Adult Stills disease

  • High and variable fever, arthritis, rash in fever, high ferritin in blood test

Childhood arthritis (juvenile arthritis)

  • A special group of chronic diseases among children of all ages (but can continue into adulthood)

Connective tissue disorders (please see below)

Ankylosing spondylitis (Ankylosing spondylitis)

Familiar Mediterranean Fever (FMF) 

  • Ethnic from the Mediterranean and North Africa, family history
  • Acute self-limiting seizures with arthritis and inflammation of the pericardium og lung membranes / serositis)

Infections (please see below)

Cancer treatment (please see below)

Arthritis / Rheumatoid Arthritis (RA)

  • Symptoms lasting two weeks or more
  • Swollen fingers / toes
  • Hard to tie hands, especially in the morning
  • The feeling of "walking on pillows", especially in the morning
  • Blood samples with increased CRP, Rheumatoid factor (RF) and anti-CCP
arthritis provides lesbian joints

Joint inflammation, Arthritis in the fingers and in the right knee, tendonitis (entesitis) in the left Achilles tendon and swollen toe (dactylite) at Psoriatic arthritis. Kivelevitch D, Biologics (2014). (CC-BY-NC 3.0)

Psoriatic arthritis

  • Occurs among 5-10% of those who have Psoriasis of the skin

Reactive arthritis

Reticulo-histiocytosis

Sarcoidosis 

  • Løfgren Syndrome
    • Both ankles, erythema nodosum / lump rose and swollen hilus lymph nodes in lungs

Still's disease (systemic childhood arthritis in children, Adult Stills disease among adults)

  • Typically, high fever, arthritis and varying mild rashes

Intestinal inflammation

Vasculitis, systemic (please see below)

Gout

  • Caused by uric acid crystals

Infections

  • Borrelia arthritis (Lyme disease) is a special form of septic arthritis that can attack the knee or other joints a few weeks or months after tick bite. The fewest tick bites lead to infection. If a tick has sucked blood for a long time, it increases the risk of infection
  • Septic arthritis caused by infection (mostly bacteria)
  • Whippel's disease (arthritis can precede other symptoms for several years)

Connective Tissue Diseases

Arthritis commonly occurs in Systemic connective tissue diseases:

Vasculitis diseases

Vasculitis diseases can also cause arthritis, most often at the onset of illness

Arthritis during cancer treatment

Diagnosis arthritis - inflammation of joints

An experienced doctor will recognize arthritis by clinical examination of joints

  • Blood tests usually show elevated CRP and erythrocyte sedimentation rate (ESR)
  • By Rheumatoid arthritis (RA), SLE and some vascular diseases are often characteristic Antibodies present
  • Gout usually show markedly elevated uric acid levels in blood and typical crystals by joint fluid examination (via rheumatologist)
  • Septic arthritis is diagnosed by joint fluid examination and / or PCR technique
  • Ultrasound and MRI examination of joints can detect early signs of arthritis
  • X-ray changes occur in later stages of disease

Treatment of arthritis - inflammation of joints

In chronic rheumatoid arthritis, the hyperactive immune system is calmed with immunosuppressive drugs to prevent the development of joint injury

Referral to rheumatologist

If arthritis - arthritis is suspected - the GP usually chooses to refer to a rheumatologist or rheumatology department after preliminary examinations (assessment of affected joints, blood and urine tests) have been performed.

You can read about your rights in arthritis disease here (Norsk Revmatikerforbund)


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