How do you know if you have inflammatory arthritis?
What is Inflammatory Arthritis?
Arthritis is painful inflammation and stiffness of the joints. Inflammatory Arthritis is an inflammation of the joints which is caused by an overactive immune system. It usually affects multiple joints of the body at the same time. It is less common than Osteoarthritis, which affects people at a later stage of life.
What are the types of Inflammatory Arthritis?
The major types include:
- Rheumatoid arthritis
- Gout and Pseudo-gout
- Ankylosing spondylitis
- Psoriatic arthritis
- Lupus, and
- Lyme disease.
What are the symptoms of Inflammatory Arthritis?
Inflammatory arthritis is usually associated with classic symptoms of inflammation like the color (warmth), dolor (pain), rubor (erythema), tumor (swelling), and functio laesa (loss of function). The most common symptoms are joint pain and stiffness, particularly in the morning, swelling and redness in the affected joints, and inflammation in other parts of the body like the skin, or organs such as the lungs and heart. If the condition is detected and treated in its early stages, the effects can be greatly decreased, or it can even disappear completely.
Rheumatoid Arthritis mainly affects the small joints of the body like hands, feet, and wrists. It can also affect larger joints such as the knees. Usually, more than one joint is affected. Also, more often, the same joints are affected on both sides of the body (symmetric arthritis). Other symptoms include early morning stiffness lasting for 30 minutes or more, decreased range of motion, joint deformities, low-grade fever, and fatigue.
Gout usually affects only one joint, typically the great toe. However, other joints can be affected as well like the small joints of the feet or hands, wrists, ankles, knees, and elbows.
Ankylosing spondylitis typically presents as back pain (starting from sacroiliac joints progressing upwards) leading to bamboo-spine. Symptoms respond well to nonsteroidal anti-inflammatory drugs and physical therapy. There is usually a similar history of the disease in the family members.
Psoriatic arthritis has additional symptoms of warmth in the joints, nail changes like pitting, cracking, or separation from the nail bed, swelling of the fingers and toes, psoriasis, fatigue, and low-grade fever.
In Lupus, in addition to joint pain and inflammation, there are symptoms like fatigue, headache and body aches, a butterfly-shaped rash across the cheeks and nose, difficulty breathing, mouth sores, dry eyes, and hair loss.
What is the difference between Osteoarthritis and Inflammatory Arthritis?
Osteoarthritis is caused by the physical wear and tear of the joints over time. It usually occurs in people after the age of 50 years.
Inflammatory Arthritis on the other hand is a chronic autoimmune condition where our immune system misidentifies our body tissues as pathogens and attacks them. It can affect people of any age, with a peak incidence in child-bearing age. It is more common in females than males.
How do you know if you have inflammatory arthritis?
After your doctor takes a detailed medical history and performs a physical examination of your joints, they may order some additional tests. These include:
- Complete blood count: which measures the levels of different blood cells
- Rheumatoid factor: present in Rheumatoid arthritis.
- Erythrocyte Sedimentation Rate (ESR) and C – reactive protein (CRP): which are indicators of inflammation
- Uric acid test: increased uric acid level in the blood indicates gout.
- Genetic tests: to identify genetic markers associated with ankylosing spondylitis.
- Imaging tests can help visualize the affected joints and look for signs of inflammation and damage. Tests like Magnetic Resonance Imaging (MRI), Computed Tomography (CT) scan, X-Ray, and Ultrasound can be done.
- Synovial Fluid analysis: to rule out Septic Arthritis and assess for crystal formation seen in gout and pseudogout.
What are the treatment options for Inflammatory Arthritis?
Inflammation is usually reversible, but joint destruction is not. Early and effective treatment is mandatory to prevent disease persistence or progression, joint destruction, and disability.
The goals of treatment are to:
- Lower the level of inflammation
- Ease the symptoms
- Stop further progression of the disease
- Reduce chances of complications
- Improve joint function, and
- Improve the quality of life.
Gout and pseudo-gout can mimic septic arthritis. Once septic arthritis has been ruled out, and the diagnosis of gout and pseudo-gout has been confirmed by performing a synovial fluid analysis, treatment with anti-inflammatory agents like oral, systemic, or intra-articular corticosteroids, NSAIDs, or Colchicine can be started. Also, urate-lowering drugs can be started if there are recurrent acute attacks of gout or associated Chronic Kidney disease.
In the case of Rheumatoid Arthritis, anti-rheumatic drugs like Methotrexate, Hydroxychloroquine, and Leflunomide are usually the first-line drugs.
Surgery is rarely needed in the early stages of inflammatory arthritis but can be considered in chronic cases of Rheumatoid arthritis.
What happens if inflammatory arthritis is not treated on time?
If left untreated, inflammatory arthritis can lead to serious infectious events, intractable or pain refractory to medications, joint stiffness, and deformities, osteoporotic fractures, and extra-articular manifestations.
References
1. Hospital for Special Surgery. 2021. Inflammatory Arthritis: Causes, Symptoms, and Treatment | HSS. [online] Available at: <https://www.hss.edu/conditions_understanding-inflammatory-arthritis-an-introduction.asp> [Accessed 21 December 2021].
If you think you have inflammatory arthritis, Straith Hospital can help. Our team of skilled physicians, nurses, therapists and more work hard to improve your strength so you can get back home safely. To learn more, give us a call at (248) 357-3360 or click here to view frequently asked questions. Schedule An Appointment!
THIS ARTICLE IS FOR EDUCATIONAL PURPOSES ONLY, IT DOES NOT CREATE A PHYSICIAN-PATIENT OR OTHER PROFESSIONAL RELATIONSHIP, AND IT SHOULD NOT BE INTERPRETED OR RELIED UPON AS MEDICAL ADVICE OR OPINION. EACH HEALTH CONDITION IS UNIQUE AND SHOULD BE EVALUATED, DIAGNOSED AND/OR TREATED WITH THE ASSISTANCE OF COMPETENT PROFESSIONALS.