Arthritis types
There are more than 150 different types of arthritic conditions. The severity, location and the progression of arthritis varies enormously from one person to another, but generally the symptoms include pain, stiffness and inflammation of the joints.
‘Rheumatism’ is not a specific disease, but rather a term used to describe a number of problems affecting the joints, muscles or soft tissues of the body. The word rheumatism is often used loosely to describe both osteoarthritis and rheumatoid arthritis, as well as other conditions such as bursitis, fibrositis, lumbago, sciatica and tendonitis.
The most common forms of arthritis are osteoarthritis, rheumatoid arthritis and gout.
Osteoarthritis
Osteoarthritis is a wear-and-tear disease that is often associated with ageing, and is most common in people over 60, although young athletic people have a slightly increased risk of developing osteoarthritis of the knee. In osteoarthritis, the protective layer (called the cartilage) that covers the ends of the bones in a joint breaks down, causing pain as the bones rub together.
Osteoarthritis commonly occurs in the knees, hips, hands or feet. Sometimes painful bone spurs, or osteophytes, can also form on the side of the end of damaged bone, such as a vertebra. In other instances, bony lumps called Heberden’s or Bouchard’s nodes may develop on the finger joints.
Being obese is a documented risk factor for osteoarthritis in weight-bearing joints such as the knees and hips. Weight loss can significantly reduce the chance of developing osteoarthritis of the knee and can alleviate knee pain in people who already have the condition.
Rheumatoid arthritis
Rheumatoid arthritis is an auto-immune disease where the body’s immune system starts to attack its own joints. The synovial membrane, which encloses the joint, becomes inflamed, synovial fluid is produced in excess, which causes the capsule around the joint to stretch and cause pain, and the inflammation in the joints eventually damages the cartilage. The characteristic swelling happens when the joint produces too much lubricating (synovial) fluid in response to the inflammation. This can restrict movement and cause considerable pain and stiffness. In addition, people with rheumatoid arthritis may suffer from fatigue, occasional fever, and a general sense of feeling unwell.
Rheumatoid arthritis commonly occurs in the hands, feet, shoulders and knees, generally in a symmetrical pattern. It occurs less frequently in the elbows, hips and neck. It affects 2 to 3 times more women than men and, while it can occur at any age, it usually begins in people aged 25 to 50.
Gout
Gout is caused by the formation of monosodium urate crystals in a joint. These deposits accumulate in the joints usually because the levels of uric acid in the blood are too high. Excess uric acid can also be deposited as crystals in the kidneys, known as kidney stones. It has now been shown that over-indulgence in food and alcohol does not cause gout, although it may make attacks worse if you suffer from gout. Some of the risk factors for developing gout are a genetic metabolic disorder, certain medications or certain types of cancer or cancer treatment.
Gout is most commonly found in the joint at the base of the big toe, but can affect other joints such as the ankles, elbows, wrists and hands. It is often episodic, with the joint involved getting progressively painful, red and swollen for several days or weeks, before returning to normal. Gout mostly affects men over 40 years old. It is quite rare in younger women, and usually occurs in women only after the menopause.
Treatment of acute attacks of gout involves anti-inflammatory drugs to reduce the pain and the joint inflammation. Aspirin must be avoided as it stops uric acid from being expelled from the body. Long-term treatment involves controlling the uric acid levels with medications such as allopurinol, reducing alcohol intake, and avoiding purine-rich foods such as anchovies, nuts, liver and kidney.
Other forms of arthritis
There are also many other conditions having arthritis as a symptom. These include:
- lupus (SLE, systemic lupus erythematosus), a chronic connective tissue disorder that typically affects women between 15 and 35 years of age;
- ankylosing spondylitis, characterised by inflammation of the spine and large joints;
- arthritis associated with inflammatory bowel disease;
- Behcet’s syndrome, a rare chronic relapsing disease affecting mainly young adults;
- infectious arthritis, caused by a bacterium, virus or fungus spreading to a joint through the bloodstream or by surgery or injury;
- juvenile arthritis, which describes a number of different arthritic conditions in children;
- polymyalgia rheumatica, a condition that causes pain in various muscles;
- pseudogout, where calcium pyrophosphate dihydrate (CPPD) crystals are deposited in the joints;
- psoriatic arthritis, a form of arthritis in people with psoriasis;
- Reiter’s syndrome, a disorder that causes the 3 seemingly unrelated symptoms of arthritis, red eyes and urinary tract problems; and
- Sjögren’s syndrome, a chronic disorder where the organs that produce lubricating fluid become inflamed and scarred leading to dryness of the eyes and mouth.
Last Reviewed: 19 February 2003
