Arthritis: What Is Arthritis and What Are Common Symptoms and Treatment Options

Arthritis is a disease characterized by inflammation in one or more joints. Arthritis causes joint pain and stiffness that exacerbates with age. The term Arthritis describes more than 100 rheumatic diseases and disorders that affect the joints, surrounding tissues, and other types of connective tissue.

Author:	Doctor Eluz Zarraga
Reviewed by:	Ana Codallo, CTO
Last Updated on Mar 21, 2023

Inflammation corresponds to one of the body's reactions to a disease or injury, causing edema or swelling, pain, and stiffness that can last a short or long time, such as arthritis, causing tissue damage.

It is essential to define the word "joint," where two or more bones meet, which are covered by cartilage, allowing joint mobilization without pain. The joints inside are surrounded by synovial fluid, also known as joint fluid; it is a transparent and viscous fluid whose function is to nourish said joints, cushion the ends of the bones, and reduce friction when the joints move. Additionally, on its surface, it presents the joint capsule, which allows said surfaces to remain in contact, surrounded by soft structures such as tendons, ligaments, and muscles that give stability and mobility to the joint.

Arthritis: Whom Does It Affect?

Arthritis is widespread, and 1 in 5 adults may have some level of arthritis, becoming more common in older people. The age and sex most affected will depend on the type of arthritis.

Arthritis can affect any age and sex; everything depends on the type of arthritis each person develops.

Arthritis: Causes

The role of genetics and the various lifestyles that could influence the development of the multiple types of arthritis is currently under study. Among the risk factors that can develop arthritis, we have:

• Age, since the joints can wear out at an older age and cause osteoarthritis.
• The most predisposed sex is female, except for gout, which is more common in men.
• Genetics.
• Obesity puts pressure on the joints, which could increase joint wear.
• Previous joint injuries could lead to some types of arthritis.
• Infectious processes, whether viral, fungal, or bacterial, affect the joints and can cause inflammation.
• The types of jobs that involve lifting loads or repetitive movements that deteriorate the joints.

What Is the ICD 10 Code for Arthritis?

The ICD / ICD 10 code for Arthritis is "M13.80" (Other specified arthritis, unspecified site).

Arthritis: Types

There are various types of arthritis with different causes, such as wear and tear, infection, and underlying disease. The most common types are osteoarthritis (OA), degenerative joint disease or osteoarthritis, and rheumatoid arthritis (RA).

Less frequent types of arthritis are lupus, gout, and psoriatic arthritis, among others.

Arthritis: Symptoms

Each type of arthritis will have symptoms and signs that may vary depending on the severity of the disease. Osteoarthritis usually does not cause any symptoms outside of the joint. Symptoms of other types of arthritis include fatigue, fever, rash, or erythema.

Depending on the type of arthritis we have:

• Pain
• Joint stiffness
• Swelling
• Joint redness or warmth
• Decreased range of motion
• Joint deformity

Arthritis: Diagnosis

The doctor will conduct a good interrogation and physical examination of the patient through the medical history. Paraclinical studies such as the following tests:

• Rheumatoid factor
• Citrullinated Anticyclic Peptides Test
• Complete Blood Count (CBC)
• C - reactive protein
• Erythrocyte sedimentation rate
• Urine test
• Study of joint fluid to be able to specify inflammatory or infectious processes
• Radiological studies in the affected structures

Arthritis: Treatment

Currently, various therapeutic options allow the patient to reduce symptoms and have a better quality of life.

The goal of treatment is to decrease pain, increase mobility and strength of the periarticular muscles, and prevent joint damage.

Treatment relies on medication, physiotherapy, occupational therapy, surgery, and alternative medicine. Therefore, the treatment should be by a multidisciplinary team that includes rheumatology, physical medicine, rehabilitation, and traumatology, if needed.

Most Frequent Types of Arthritis

Osteoarthritis

Osteoarthritis (OA), the most common arthritis, is a universal disorder that affects both sexes and all races and appears after trauma or injury to a joint or with age.

It is characterized by articular cartilage softening and disintegrating, causing the bones to rub against each other and the joints to become inflamed with consequent pain, bone damage, and even the formation of new bone (called osteophytes) at the joint margins.

It can occur in one or more joints in the body, usually weight-bearing joints such as the hips, knees, and spine. The fingers, big toes, and shoulders may also be affected.

Among the risk factors for developing osteoarthritis are age, obesity, previous joint injuries, family history, and high-impact activities or excessive use of the joints.

What Happens in Osteoarthritis?

Articular cartilage becomes rigid and loses its elasticity, causing wear and tear, thus losing its ability to cushion the joint. Therefore, due to the deterioration of the cartilage, the tendons and ligaments stretch and produce pain, instability, and joint friction.

Osteoarthritis: Symptoms

• The usual symptom is a pain in the joint or referred to another joint. It is generally not severe and becomes worse with weight bearing.
• Stiffness is a common symptom; it tends to be perceived intermittently, particularly when a person resumes activity after rest. Patients report the joint as being "stuck" when sitting, and it takes some time to "collapse" when they begin to move. Said stiffness is upon awakening lasting less than 30 minutes or after sitting for a long time.
• There can be painful or sensitive points in the affected joint and decreased joint ranges.
• When performing joint movement, crepitus can be present due to the rubbing of the worn joint surfaces.
• Bone formation can be present in periarticular areas (osteophyte formation).
• You may find painful nodules or lumps around the distal joints.
• The symptoms depend on the type and number of joints affected since it can manifest difficulty going up and down stairs, grabbing or squeezing things, and getting dressed, among others.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an autoimmune disease that occurs in young adults, where the body's defense system destroys or erodes the lining of the joints.

That is why it is an autoimmune disease, since the immune system destroys the joints, recognizing them as foreign, causing inflammation, and can spread to nearby tissues, damaging cartilage and bone.

It can affect other body areas, such as the skin, eyes, and nerves.

It mainly affects the female sex, and they develop lumps on the skin called rheumatoid nodules that form on joints with pressure, such as the knuckles, elbows, or heels.

What Happens in Rheumatoid Arthritis?

It is not clear what causes rheumatoid arthritis.

Some researchers believe that the immune system becomes "confused" after infection with bacteria or a virus and begins to attack the joints. This battle can spread to other areas of the body.

Scientists suggest that two of the body's chemicals linked to inflammation, tumor necrosis factor (TNF) and interleukin-1, activate other parts of the immune system in rheumatoid arthritis. Drugs that block TNF, interleukin-1, and interleukin-6 may improve symptoms and prevent joint damage.

Rheumatoid Arthritis: Symptoms

They can appear suddenly or progressively and are often more severe than in osteoarthritis.

• Pain, stiffness, and swelling in small joints (fingers and toes), wrists, and large joints such as shoulders, knees, hips, and ankles. The same joints are affected on both sides of the body, usually with a symmetrical pattern.
• There can be more than one swollen joint, usually small joints in the wrists, hands, or feet.
• Redness and local heat in said joints.
• Morning stiffness that lasts for hours or even most of the day.
• They may also present symptoms in the rest of the body, such as fatigue, tiredness, little desire to eat, or depression.
• They may present rheumatoid nodules that show as lumps under the skin; these appear on the elbows and the Achilles tendon.
• Symptoms can present in the form of an outbreak.
• It can affect other organs, such as the heart, lungs, blood vessels, bones, and eyes.

Psoriatic Arthritis

Patients have inflammation of the skin and joints. The skin presents irregular, raised, red and white areas with scales, affecting the tips of the elbows and knees, the scalp, the navel, and the genital region. Only 10 to 30% of people with psoriasis develop psoriatic arthritis.

What Happens in Psoriatic Arthritis?

This type of arthritis generally starts between the ages of 30 and 50, but there are also cases where it can begin in childhood. It affects both sexes. Skin lesions appear before joint involvement.

Psoriatic Arthritis: Symptoms

• Swollen fingers and toes.
• Pitted or discolored nails.
• In some people, only one joint or a few joints are affected.
• Sometimes it affects the spine or just the fingers and toes.

Gout

What Is Gout?

The accumulation of uric acid crystals in a joint causes gout. The big toe, knee, and wrist are the joints that are frequently affected.

What Happens in the Gout?

A sudden and sharp pain occurs in the big toe after ingesting a drink or drug, which is the type of stress that can trigger the crisis. Such a crisis can last between 3 and 10 days, even without treatment. It may be months or years before you have another one, but they may become more frequent over time. If left untreated, gout can affect the joints and kidneys.

Gout: What Are the Signs and Symptoms?

• Severe joint pain: This will probably be in your big toe, but it could also be in your ankles, knees, elbows, wrists, or fingers.
• Swelling and redness in the joint, with stiffness.

Lupus

What Is Lupus?

Called SLE for its acronym Systemic Lupus Erythematosus, it is an autoimmune disease that affects the joints and many organs, such as the skin, lungs, kidneys, heart, and brain. It is more common in females than males.

What Are the Signs and Symptoms?

• In addition to pain and swelling in the joints, they may have chest pain, fatigue, hair loss, facial skin rash, and sensitivity to sunlight.
• Blue or white fingers or toes when exposed to cold (Raynaud's phenomenon)
• Blood disorders, such as anemia and low levels of white blood cells or platelets

What Happens in Lupus?

The immune system causes inflammation and pain throughout the body, from the joints to the organs and the brain.

Conclusion

In summary, there are more than 100 types of arthritis, and we have discussed the most frequent types. Pain, joint stiffness, and swelling of the affected joints are common in almost all types. It is essential to consult your doctor if you present the symptoms described and determine if it is arthritis to receive the best treatment.

Dr. Rikard Holmdahl: KOL #1 for Arthritis

According to KOL's technology, Dr. Rikard Holmdahl is the top ranking Key Opinion Leader (worldwide) for Arthritis. You can see Dr. Rikard Holmdahl's KOL resume and other concepts for which they rank #1 worldwide.

Rikard Holmdahl

Karolinska Institutet, 171 77 Stockholm, Sweden

KOL #1 (worldwide) for: Arthritis

Rikard Holmdahl is a Swedish physician and immunologist. He was appointed as a full professor and the head of Medical Inflammation Research (MIR) unit at Lund University in 1993. In 2008, Rikard and his whole research group were recruited to Karolinska Institute. His team was the first to discover and positionally clone a single nucleotide polymorphism at the Ncf1 gene causing susceptibility to autoimmune diseases in rat models. Rikard was an adjunct member of the Nobel Committee for physiology or medicine between 2016 and 2021, and was ranked 2nd among the top immunology scientists in Sweden in 2021.Rikard Holmdahl obtained his Doctor of Philosophy and Medical Doctor degrees at Uppsala University in 1985 and 1987, respectively. After his clinical residency training during 1988-1989, he started his research fellowship and was promoted as Associate Professor at Swedish Medical Research Council in 1990. He became a full professor since 1993, and he is now the head of the MIR Division at Karolinska Institute (2008–present). He was a member of the Nobel Assembly during 2014-2021 and an adjunct member of the Nobel committee for physiology or medicine during 2016-2021. He is also a member of the Royal Swedish Academy of Science since 2017.

Biography courtesy of: https://en.wikipedia.org/wiki/Rikard_Holmdahl

Recent articles about Arthritis