Understand the common symptoms of arthritis: swelling, stiffness and As a disease, arthritis is more complicated and varied than most people imagine. Joint stiffness may occur with or without joint pain. joint– the fingers and hands, wrists, elbows, knees, ankles, feet, shoulders, hips, and Over-the-Counter Medicines. A sharp shooting pain from the shoulder to the elbow. It can occur in almost any joint in the body - most commonly in the fingers, hips, knees. Osteoarthritis (OA) is a painful, degenerative joint disease that often involves the hips, knees, neck, lower back, or small joints of the hands. involves various joints in the fingers, thumbs, wrists, elbows, shoulders, knees, feet, and ankles. Usually, people with osteoporosis need pain relief when they are.
Causes, for Elbow, Hip, Relief Hand Symptoms Shoulder, and and Pain Options Pain: Finger Joint Knee,
Diagnosis is made with reasonable certainty based on history and clinical examination. The typical changes seen on X-ray include: In , the American College of Rheumatology , using data from a multi-center study, developed a set of criteria for the diagnosis of hand osteoarthritis based on hard tissue enlargement and swelling of certain joints. Severe osteoarthritis and osteopenia of the carpal joint and 1st carpometacarpal joint.
Primary osteoarthritis of the left knee. Note the osteophytes , narrowing of the joint space arrow , and increased subchondral bone density arrow.
Damaged cartilage from sows. In a healthy joint, the ends of bones are encased in smooth cartilage. Together, they are protected by a joint capsule lined with a synovial membrane that produces synovial fluid. The capsule and fluid protect the cartilage, muscles, and connective tissues. With osteoarthritis, the cartilage becomes worn away.
Spurs grow out from the edge of the bone, and synovial fluid increases. Altogether, the joint feels stiff and sore. Osteoarthritis can be classified into either primary or secondary depending on whether or not there is an identifiable underlying cause.
Both primary generalized nodal osteoarthritis and erosive osteoarthritis EOA, also called inflammatory osteoarthritis are sub-sets of primary osteoarthritis. EOA is a much less common, and more aggressive inflammatory form of osteoarthritis which often affects the distal interphalangeal joints of the hand and has characteristic articular erosive changes on x-ray.
Related pathologies whose names may be confused with osteoarthritis include pseudo-arthrosis. This is derived from the Greek roots pseudo- , meaning "false", and arthr- , meaning "joint", together with the ending -osis used for disorders. Radiographic diagnosis results in diagnosis of a fracture within a joint, which is not to be confused with osteoarthritis which is a degenerative pathology affecting a high incidence of distal phalangeal joints of female patients. A polished ivory-like appearance may also develop on the bones of the affected joints, reflecting a change called eburnation.
Lifestyle modification such as weight loss and exercise and analgesics are the mainstays of treatment. Acetaminophen also known as paracetamol is recommended first line with NSAIDs being used as add on therapy only if pain relief is not sufficient. For overweight people, weight loss may be an important factor. Moderate exercise may be beneficial with respect to pain and function in those with osteoarthritis of the knee and hip.
Lateral wedge insoles and neutral insoles do not appear to be useful in osteoarthritis of the knee. The pain medication paracetamol acetaminophen is the first line treatment for osteoarthritis. Another class of NSAIDs, COX-2 selective inhibitors such as celecoxib are equally effective when compared to nonselective NSAIDs, and have lower rates of adverse gastrointestinal effects, but higher rates of cardiovascular disease such as myocardial infarction.
Failure to achieve desired pain relief in osteoarthritis after 2 weeks should trigger reassessment of dosage and pain medication. Their appropriateness is uncertain, and opioids are often recommended only when first line therapies have failed or are contraindicated.
Use of the antibiotic doxycycline orally for treating osteoarthritis is not associated with clinical improvements in function or joint pain. A Cochrane review from concluded that reasonably reliable evidence is available only for use of topical diclofenac and ketoprofen in people aged over 40 years with painful knee arthritis.
Joint injection of glucocorticoids such as hydrocortisone leads to short term pain relief that may last between a few weeks and a few months. A Cochrane review found that intra-articular corticosteroid injections of the knee did not benefit quality of life and had no effect on knee joint space; clinical effects one to six weeks after injection could not be determined clearly due to poor study quality.
If the impact of symptoms of osteoarthritis on quality of life is significant and more conservative management is ineffective, joint replacement surgery or resurfacing may be recommended.
Evidence supports joint replacement for both knees and hips as it is both clinically effective,   and cost-effective. Osteotomy may be useful in people with knee osteoarthritis, but has not been well studied and it is unclear whether it is more effective than non-surgical treatments or other types of surgery.
For people who have shoulder osteoarthritis and do not respond to pharmaceutical approaches, surgical options include a shoulder hemiarthroplasty replacing a part of the joint , and total shoulder arthroplasty replacing the joint. The effectiveness of glucosamine is controversial. A Cochrane review of clinical trials of chondroitin found that most were of low quality, but that there was some evidence of short-term improvement in pain and few side effects; it does not appear to improve or maintain the health of affected joints.
Avocado—soybean unsaponifiables ASU is an extract made from avocado oil and soybean oil  that is sold under many brand names worldwide as a dietary supplement  and as a drug in France. The review noted a high-quality two-year clinical trial comparing ASU to chondroitin , which has uncertain efficacy in osteoarthritis; the study found no difference between the two. Devil's claw ,  curcumin ,  phytodolor,  SKIX   and s-adenosyl methionine SAMe   may be effective in improving pain.
There is tentative evidence to support cat's claw ,  hyaluronan ,  methylsulfonylmethane MSM ,   and rose hip. There is little evidence supporting benefits for some supplements, including: There is insufficient evidence to make a recommendation about the safety and efficacy of these treatments.
Routine use of the dietary supplement s-adenosyl methionine is not advised as there have not been sufficient high-quality trials performed to evaluate its effect.
While acupuncture leads to improvements in pain relief, this improvement is small and may be of questionable importance. While electrostimulation techniques such as TENS have been used for twenty years to treat osteoarthritis in the knee, there is no conclusive evidence to show that it reduces pain or disability.
Further research is needed to determine if balnotherapy for osteoarthritis mineral baths or spa treatments improves a person's quality of life or ability to function. There is low quality evidence that therapeutic ultrasound may be beneficial for people with osteoarthritis of the knee, however further research is needed to confirm and determine the degree and significance of this potential benefit.
There is weak evidence suggesting that electromagnetic field treatment may result in moderate pain relief, however further research is necessary and it is not known if electromagnetic field treatment can improve quality of life or function. Globally, as of [update] , approximately million people had osteoarthritis of the knee 3.
As of [update] , osteoarthritis globally causes moderate to severe disability in As of [update] , osteoarthritis affected In the United States, there were approximately , hospitalizations for osteoarthritis in , a rate of 31 stays per 10, population.
By payer, it was the second-most costly condition billed to Medicare and private insurance. Evidence for osteoarthritis found in the fossil record is studied by paleopathologists , specialists in ancient disease and injury. Osteoarthritis has been reported in fossils of the large carnivorous dinosaur Allosaurus fragilis.
Human knee osteoarthritis may have doubled since the midth century, per a study of skeletons. Osteoarthritis is derived from the prefix osteo- from Ancient Greek: There are ongoing efforts to determine if there are agents that modify outcomes in osteoarthritis.
Sprifermin is one candidate drug. There is also tentative evidence that strontium ranelate may decrease degeneration in osteoarthritis and improve outcomes. As well as attempting to find disease-modifying agents for osteoarthritis, there is emerging evidence that a system-based approach is necessary to find the causes of osteoarthritis.
Research is thus focusing on defining these early pre-osteoarthritis changes using biological, mechanical, and imaging markers of osteoarthritis risk, emphasising multi-disciplinary approaches, and looking into personalized interventions that can reverse osteoarthritis risk in healthy joints before the disease becomes evident. Gene transfer strategies aim to target the disease process rather than the symptoms.
Cell-mediated gene therapy is being studied. Guidelines outlining requirements for inclusion of soluble biomarkers in osteoarthritis clinical trials were published in ,  but as of [update] , there are no validated biomarkers for osteoarthritis. A systematic review of biomarkers for osteoarthritis looking for molecules that could be used for risk assessments found 37 different biochemical markers of bone and cartilage turnover in 25 publications.
One problem with using a specific type II collagen biomarker from the breakdown of articular cartilage is that the amount of cartilage is reduced worn away over time with progression of the disease. As a result, a patient can eventually have very advanced osteoarthritis with none of this biomarker detectable in their urine.
Another problem with a systemic biomarker is that a patient can have osteoarthritis in multiple joints at different stages of disease at the same time, so the biomarker source cannot be determined.
Some other collagen breakdown products in the synovial fluid correlated with each other after acute injuries a known cause of secondary osteoarthritis but did not correlate with the severity of the injury. From Wikipedia, the free encyclopedia.
Osteoarthritis Synonyms Degenerative arthritis, degenerative joint disease, osteoarthrosis The formation of hard knobs at the middle finger joints known as Bouchard's nodes and at the farthest finger joints known as Heberden's nodes are a common feature of osteoarthritis in the hands. Occupational disease and Occupational injury. Secondary osteoarthritis of the ankle due to an old bone fracture in an year-old woman.
Hip joint with osteoarthritis . MRI of osteoarthritis in the knee, with characteristic narrowing of the joint space. Histopathology of osteoarthrosis of a knee joint in an elderly female. Radiographic classification of osteoarthritis. Archived from the original on 18 May Retrieved 13 May Archived from the original on Occupational Exposures and Osteoarthritis: A systematic review and assessment of medical, social and ethical aspects.
Graphic design by Anna Edling. Retrieved 8 April World Journal of Orthopedics. Arthritis and Osteoporosis Victoria. Prevalence of Arthritis in the United States". Archived from the original on 29 December Revista Brasileira de Reumatologia in Portuguese. Archived from the original on 21 April Retrieved 20 April The Medical Clinics of North America.
Journal of the American Board of Family Medicine. The Journal of Clinical Investigation. With special reference to unicompartmental replacement and osteotomy of the knee". The Journal of Bone and Joint Surgery. Annals of the Rheumatic Diseases. Knee Surgery, Sports Traumatology, Arthroscopy. The Journal of Rheumatology. Annals of Internal Medicine. Journal of Musculoskeletal Medicine. Tissue lining the joint can become thick, and may wear away surrounding ligaments, cartilage and bone as it spreads.
Rheumatoid arthritis usually occurs in a symmetrical pattern, meaning that if one knee or hand has it, the other usually does, too. The cause of rheumatoid arthritis is unknown, although it appears to be an autoimmune disease. When the body's immune system does not operate as it should, white blood cells that normally attack bacteria or viruses attack healthy tissue instead — in this case, the synovium, or joint tissue.
As the synovial membrane the thin layer of cells lining the joint becomes inflamed, enzymes are released. Over time, these enzymes and certain immune cells damage the cartilage, bone, tendons and ligaments near the joint.
Some research suggests that a virus triggers this faulty immune response. However, there is not yet convincing evidence that a virus is the cause of rheumatoid arthritis. At the same time, it appears that some people are more likely to get the disease because of their genetics. Environmental factors may also be important.
For example, smoking is a risk factor for rheumatoid arthritis. Rheumatoid arthritis, the most disabling form of arthritis, generally affects more than one joint at a time. Commonly affected joints include those in the hands, wrists, feet, ankles, elbows, shoulders, hips, knees and neck. Rheumatoid arthritis can result in loose, deformed joints, loss of mobility and diminished strength.
It also can cause painless lumps the size of a pea or acorn, called rheumatoid nodules. These develop under the skin, especially around the elbow or beneath the toes. Generally, the pain of rheumatoid arthritis is described as a dull ache, similar to that of a headache or toothache.
Pain is typically worse in the morning. It is not rare to have 30 minutes to an hour or more of morning stiffness. On days when the disease is more active, you may experience fatigue, loss of appetite, low-grade fever, sweats and difficulty sleeping. Because rheumatoid arthritis is a systemic disease meaning it can affect the entire body , you also may have inflammation in other areas, including the heart, lungs or eyes.
Symptoms vary between people and even in one person over time. People with mild forms of the disease are bothered by pain and stiffness, but they may not experience any joint damage. For other people, damage occurs early, requiring aggressive medical and surgical treatment. People with rheumatoid arthritis may notice worsening and improvement for no apparent reason.
Although this disease most often afflicts people between the ages of 20 and 50, it may affect children and the elderly. Of the 2 million people with rheumatoid arthritis in the United States, at least 75 percent are women. Pain, swelling, limited motion, warmth and tightness around affected joints, which most commonly include the hands and wrists, feet and ankles, elbows, shoulders, neck, knees and hips, usually in a symmetrical pattern.
Over time, joints may develop deformities. Fatigue, soreness, stiffness and aching, particularly in the morning and afternoon described as morning stiffness and afternoon fatigue.
Your doctor will ask about your symptoms and medical history, and will examine you. You also may be sent for a blood test. An abnormal antibody, called the rheumatoid factor RF , is found in the blood of 60 percent to 70 percent of patients with rheumatoid arthritis. However, having RF does not necessarily mean you have rheumatoid arthritis.
Many people who do not have rheumatoid arthritis can have RF appear in their blood. While it is more specific, the diagnosis of rheumatoid arthritis cannot be based solely on a blood test that is positive for anti-CCP. Other blood tests may be performed to look for other causes of joint pain. You may hear about a checklist of symptoms called criteria for diagnosing rheumatoid arthritis.
Although many physicians use this checklist as a guide, it is important to know that some patients with rheumatoid arthritis do not have many of the symptoms on the list, especially if their disease is mild. And some people with other forms of arthritis may meet criteria for rheumatoid arthritis.
The diagnosis of rheumatoid arthritis relies mostly on the experience and judgment of the doctor, and is based on the "big picture" of symptoms, examination and test results. Most people with rheumatoid arthritis have chronic long-lasting symptoms. They experience periods when symptoms get worse, called flare-ups, and periods when symptoms improve. Rarely, symptoms and signs of the disease disappear, called a remission.
There is no way to prevent rheumatoid arthritis. However, smoking is a risk factor for rheumatoid arthritis. So this is one more reason not to smoke. The treatment of rheumatoid arthritis has improved dramatically in the past 50 years. A comprehensive approach that combines medications, rest balanced with exercise, lifestyle modifications, and sometimes surgery, can help many people to lead normal lives.
The most important goals in treating rheumatoid arthritis are maintaining your ability to move and function, reducing pain, and preventing future joint damage. Early diagnosis and treatment are essential. If control of disease is achieved soon after symptoms begin, long-term outcomes tend to be good and quality of life and length of life may be normal. The treatments themselves may cause problems. You and your doctor will have to weigh the risks and benefits of any medication or other treatment that is available for this disease.
Medications Certain medications relieve the symptoms of rheumatoid arthritis such as pain and swelling , while other medications slow the progress of the disease. Side effects occur in a minority of patients. These include upset stomach, ulcers, reduced kidney function or allergic reactions. Newer NSAIDs, such as celecoxib Celebrex , may provide the same benefits for arthritis as older medications but with less risk of ulcers. However, the risk of ulcers is not zero.
One study showed that for people at highest risk those with recent bleeding ulcer , up to 10 percent of those treated with celecoxib developed a new ulcer. In addition, the risk was similar for these high-risk patients taking celecoxib and those taking an older agent diclofenac combined with the acid blocker omeprazole. Corticosteroids, such as prednisone Deltasone and other brand names , reduce inflammation. However, they have little lasting benefit and come with a long list of troubling side effects, such as easy bruising, thinning of the bones, cataracts, weight gain, puffy face, diabetes and high blood pressure, among others.
If you do use corticosteroids, follow your doctor's recommendations closely. Your doctor may prescribe a corticosteroid to relieve occasional flare-ups, and then gradually taper you off the medication. Stopping corticosteroid therapy suddenly can be dangerous.
Osteoarthritis - symptoms, diagnosis, treatment
Read about the common causes of joint pain, including injury and arthritis. See your GP if you have persistent symptoms of osteoarthritis. You should go to hospital immediately for treatment if you have a very swollen knee. a fracture – read about a broken arm or wrist, broken leg, broken ankle or hip fracture · reactive. Over time, if the arthritis is not treated, the bones that make up the joint can lose their normal shape. This causes more pain and further limits motion. Having painful arthritis in your wrist can make it hard to do many everyday activities. are several treatment options available to help relieve your painful symptoms and stay active. As the disease progresses, there is a gradual loss of cartilage. . Finger and thumb mobility—To determine how well your tendons and joints.