Arthritis: inflammatory joint disease

arthritis-inflammatory-joint-disease

Arthritis is a painful joint inflammation that, if left untreated, can result in complete destruction of the articular cartilage. Unlike arthritis, arthritis can occur in young people and children.

The term arthritis comes from the Greek and means translated as much as inflamed joint. An arthritis can basically occur on any joint of the body. If only one or a few joints are affected, the doctor speaks of a mono- or oligoarthritis. If several joints are affected, it is called a polyarthritis. Joint inflammation can occur acutely, but also take a chronic, so lengthy, course.

Typical symptoms of arthritis

Typical signs of arthritis include overheating, redness and painful swelling of the affected joint. In addition, an externally palpable joint effusion or even pus formation in the joint can occur. Also typical for an arthritis are pain in the resting state, which become stronger when the joint is loaded. In addition, flu-like symptoms such as fever , fatigue and loss of appetite may occur at the beginning of the illness .

In later stages sufferers usually complain of a morning stiffness of the joints, whereby even simple activities, such as closing a button or gripping an object are possible only with great effort.

Arthritis can also affect children and even babies. Small children often refuse to walk and would like to be carried. Flu-like symptoms are also common in children with arthritis.

If an arthritis is not treated in time, mucous membrane proliferations occur, which increasingly attack and destroy the cartilage layer in the joint. As a result, sometimes massive joint damage with typical joint deformations, which can lead to severe movement restrictions to the complete loss of function of the joint.

Varied causes of arthritis

Arthritic inflammation can arise in different ways.

  • Infections with bacteria and other pathogens
  • Autoimmune diseases, such as rheumatism or psoriasis
  • Metabolic diseases such as gout
  • arthrosis

Depending on which of the causes is in question, the arthritis is divided into different forms:

  • Rheumatoid arthritis: By far the most common form of arthritis is rheumatoid arthritis (rheumatism). Rheumatoid arthritis is an autoimmune disease in which the immune system classifies and attacks the body’s own mucous membrane as foreign. This leads to painful joint inflammation with initially flu-like symptoms. In Germany, about 800,000 people are affected. Around 13,000 of these patients are children and adolescents under the age of 18. When the disease begins before the age of sixteen, it is also called juvenile idiopathic arthritis. Heredity seems to play a role as cause.
  • Infectious (bacterial) arthritis: A common cause of arthritis is infection with bacteria and other germs. Most of these are staphylococci and streptococci as well as viruses and fungi. These can get into the joint through a wound, surgery or syringe. In addition, however, pathogens can also migrate from another source of infection in the body via the bloodstream into the joint. The infectious forms of arthritis include so-called reactive arthritis. This leads to acute arthritis a few weeks after having undergone bacterial urinary tract, respiratory or gastrointestinal infection.
  • Metabolic diseases: Metabolic diseases such as gout can lead to joint inflammation. Strong uric acid increases in the blood are here responsible for the formation of uric acid crystals, which then deposit in the joints. This leads to acute inflammatory reactions in the joints with severe swelling and pain. One speaks then also of an acute Gichtanfall.
  • Osteoarthritis / Activated Osteoarthritis: Arthritis may also occur as a result of osteoarthritis. Both diseases are to be separated from each other. While osteoarthritis is a degenerative disease with gradual, usually age-related, joint wear and tear, arthritis is an acute joint inflammation. However, as a result of the direct rubbing of the articular surfaces in conjunction with an advanced arthritis and the abrasion of the smallest cartilage particles into the joint space, an acute inflammation, ie an arthritis, can also occur here. The doctor also speaks in this context of an inflammatory activated arthritis.   
  • Psoriatic arthritis : In about one third of all psoriasis patients in addition to the skin lesions and arthritis, which are referred to as psoriatic arthritis.

In addition, autoimmune diseases can be the cause of arthritis.

Diagnosis of arthritis

If joint inflammation occurs, it is important to clarify what type of arthritis is involved in order to treat it quickly and properly.

For this purpose, the doctor will first detail the medical history ( anamnesis ). He asks for the exact symptoms and concomitant symptoms. It is also important to know if there were any illnesses, injuries or operations in advance. If a rheumatoid arthritis is suspected, the doctor also wants to know whether similar symptoms also occur or have occurred in close relatives. This is followed by an in-depth physical examination in which the joint is visually examined and scanned. In addition, the mobility is tested.

Blood test

As a rule, a blood test is also carried out. Mostly one finds the pathogens that have triggered the arthritis in the blood. Almost always elevated inflammatory levels are detected. If rheumatoid arthritis is suspected, specific rheumatism factors may be additionally tested. If gout is suspected, it will be investigated if uric acid levels in the blood are elevated. If an infectious arthritis is suspected, some of the pus or fluid of the joint effusion from the joint may also be punctured with a needle and this sample subsequently examined for the pathogens.

Imaging procedures

To further assess the disease, imaging techniques such as X-rays , ultrasound , computed tomography ( CT ), magnetic resonance imaging ( MRI ), or articulation can also be performed.

Therapy of arthritis depends on cause

Arthritis is a serious condition. Untreated, the articular cartilage can be irretrievably damaged or even destroyed within a short time. It is therefore important to act as soon as possible. The treatment of arthritis depends on the cause and form of joint inflammation.

Acute arthritis

Acute forms of arthritis are usually caused by infection, but can also occur in other types of arthritis. Treated in time, they can usually heal completely without causing lasting damage. The following treatment options are available:

  • It is important to protect the affected joint, to cool and to store high in order to reduce the swelling.
  • Painkillers help relieve the pain (especially at night).
  • Depending on which pathogens are responsible for the inflammation, antibiotics, antiviral drugs, antifungals and anti-inflammatory and the immune reaction-reducing drugs, such as diclofenac or cortisone , administered. These can be given as tablets or infusion. Sometimes the drug is injected directly into the joint.
  • In advanced stages, it may be necessary to surgically remove pus and fluid retention during joint pivoting.
  • Then the joint is thoroughly rinsed. This medication can also be brought directly to the site of inflammation.
  • Drainage can also help drain newly formed pus and joint effusion more easily.

Rheumatoid arthritis

Rheumatoid arthritis is the most common permanent arthritis and not curable. Recognized at an early stage, disease progression can be effectively delayed and the symptoms sustainably alleviated. The therapy consists of several pillars:

  • Slow-acting basic medicines fight the inflammation permanently, but only work after several weeks.
  • For the acute treatment of inflammation therefore fast acting cortisone drugs are used.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) also have an anti-inflammatory effect and additionally combat the pain.
  • Physiotherapy, physiotherapy and occupational therapy maintain mobility and help to better master everyday life.
  • In justified cases, joint-preserving operations can be performed and artificial joints used.

Chronic arthritis

Chronic courses with recurring inflammatory arthritis are usually caused by existing underlying diseases such as gout, psoriasis and rheumatism. Here on the one hand the respective Ekrankung must be treated and additional measures are taken, in order to avoid a damage of the joints.

Gouty arthritis

In a gout disease, it is important to lower the uric acid level and keep permanently low. For this it is necessary to change the diet to a low-purine diet. If a diet alone is not enough, uric acid-lowering medications can also be given. If there is still an acute attack of gout, special gout medications (colchicine), non-steroidal anti-inflammatory drugs (NSAIDs) and glucocorticoids are used. If these do not show the desired effect, interleukin-1β antibodies can also be used.

Psoriatic arthritis

Joint inflammation as a result of psoriasis is not curable but easy to treat. They are also treated with anti-inflammatory and analgesic medications. In addition, physiotherapy can be used. In addition , basic therapies include biologics that dampen the overreaction of the immune system.

Arthritis: What you can do yourself

You can not prevent arthritis directly. However, you can do a lot to keep your joints healthy.

  • Regular exercise is good for the joints. Above all, you should choose joint-friendly sports such as swimming , walking and cycling.
  • Pay attention to good shoes that are comfortable and relieve the joints.
  • Remove obesity. Every pound less relieves the joints.
  • In particular, if you suffer from gout, you should pay attention to the purine content of foods and change the diet to low-purine foods.
  • Quit smoking. This is especially true for people with rheumatoid arthritis. The consumption of tobacco products has a negative influence on the course of the disease.