Septic Arthritis

Septic Arthritis

In septic arthritis or sometimes called infectious arthritis your joints can become infected by any germ entering your blood. If, for example, a boil or other infection releases the staphylococcal bacterium into your blood, it can spread to a knee or some other joint. The pain is usually intense and sudden.

Gonorrhea, a sexually transmitted bacterial disease, can cause painful joints and rash.

Lyme disease can lead to arthritis. After a tick bite, a red or pink disk-shaped rash may appear, followed by fever, chills, sore throat, fatigue and nausea. Weeks later, stiffness and pain may occur in your joints.

If you have tuberculosis, you are at risk for a form of infectious arthritis called tuberculous arthritis. In more than three-quarters of all cases a single large joint is affected. Joint pain, stiffness, swelling and restriction of movements are associated with loss of appetite, weight. loss, night sweat and bodily discomfort and unease. Hepatitis B, rubella (German measles), mumps and other diseases caused by viruses also can lead to arthritis.

Treatment Options:

Joint drainage and antibiotics are the treatment options for septic arthritis.

Joint Drainage:

Three purposes are served when joint drainage – removal of the infected synovial fluid from the joints – is aimed for the treatment of septic arthritis. The three purposes are:

• Removal of the bacteria from the joint
• Reduction of the pressure on the joint
• Acquiring sample for bacteria and other organism tests

The most common method for removing joint fluid is arthroscopic surgery during which special surgical tools and tiny cameras are inserted through small incisions around the joint to access and drain the fluid around the joint.

Fluid from the joints can also be removed through needle. This process is called arthrocentesis which is repeated daily until no bacteria is found in the fluid.

Hips are more difficult to reach through arthrocentesis and arthroscopic. Hence an open surgery is required for removal of the fluid by way of hips.

Antibiotics:

Your doctor works to find out the bacteria that is causing your infection and then suggests you the most effective antibiotics accordingly. At first, the antibiotics can be given to you through a series of shots and then you may be advised to switch to oral intake

Gouty Arthritis

Gouty Arthritis

Gout generally attacks older men and can come on suddenly, resulting in intense pain and swelling in a single joint of your foot, often at the base of the big toe. An excessive concentration of uric acid in your body can cause microscopic crystals to form in the fluids that lubricate the affected joint. A painful inflammation occurs as your body tried to rid itself of the crystals.

About one million people in the United States suffer from gouty arthritis. It is more common in men than women. In women, it usually attacks after menopause while in men it bothers after puberty, more severely at the age of 75.

Risk Factors:

Besides an inherited incapability to take care of uric acid other risk factors for gouty arthritis include:

• Obesity
• Excessive weight gain (especially in youth)
• Moderate to heavy alcohol intake
• High blood pressure
• Abnormal kidney function

There are some drugs which can contribute to gouty arthritis such as:

• Thiazide diuretics,
• Tuberculosis medications (pyrazinamide and ethambutol)
• Niacin
• Cyclosporine
• Low-dose aspirin, etc

If you are suffering or have suffered one of the following diseases, you are at a risk for gouty arthritis.

• Hemoglobin disorders
• Leukemia
• Lymphomas

Treatment:

Following are the treatment methods of gouty arthritis that are commonly suggested by doctors worldwide.

• Dietary changes can help reduce uric acid levels in the blood. It is purine chemicals that are converted into uric acid by our body. Therefore, purine rich foods are to be avoided. Shellfish and other sea foods in general and organ meats such as brains, kidneys, etc, are rich in purine. Dairy foods help to reduce the risk.

• Weight reduction is definitely going to save you from recurring gouty arthritis attacks.

• In terms of medications, pain relievers and anti inflammatory agents are prescribed by doctors.

Degenerative Arthritis

Degenerative Arthritis

Degenerative arthritis or degenerative joint disease or Osteoarthritis or osteoarthrosis makes up about half of all kinds of arthritis. Essentially a joint failure, by the age of 65 years, 80 percent of people show X-ray evidence of the disease. Men and women are both affected, but it is more severe and more generalised in older women. It may affect any joint in your body. Initially it tends to strike only one joint. But if your fingers are affected, multiple hand joints may become arthritic.

With osteoarthritis, the problem lies in the cartilage that cushions the ends of bones in your joints. Over time, the cartilage deteriorates and its smooth surface roughens. Eventually, if the cartilage wears down com¬pletely, you may be left with bone rubbing on bone and the ends of your bones become damaged. This is generally painful.

Some scientists believe the cartilage damage may be due to an imbal¬ance of enzymes released from the cartilage cells or from the lining of the joint. When balanced, these enzymes allow for the natural breakdown and regeneration of cartilage. But too much of the enzymes can cause the joint cartilage to break down faster than it’s rebuilt. The exact cause of this enzyme imbalance is unclear.

Your body goes to work repairing the damage, but the repairs may be inadequate, resulting instead in growth of new bone along the sides of tl1e existing bone, which produces prominent lumps, most often on hands and feet. Each of the steps in this repair process produces pain. The pain and tenderness over the bony lumps may be most marked early in the course of the disease and less evident later on.

If you’re fortunate enough to live a long life, you’ll almost surely experience one or more painful joints, because osteoarthritis affects almost everyone as they age. Osteoarthritis most often develops after age 45. In young people, in the absence of a joint injury, osteoarthritis is relatively rare. Affected individuals often have a family history of osteoartl1ritis.

Although an active lifestyle may slow the process, almost all people older tl1an 60 have mild symptoms in the neck or spine. Many older adults have osteoarthritis but don’t know it until their physicians see it on a routine X-ray.

If you have osteoarthritis, you may experience the following symptoms:

• Pain in a joint during or after use
• Discomfort in a joint before or during a change in the weather
• Swelling and stiffness in a joint, particularly after using it
• Bony lumps on the middle or end joints of your fingers or the base of your thumb
• Loss of flexibility of a joint

Osteoarthritis commonly occurs in the neck or back. Disks between vertebrae are made of cartilage. Like cartilage, the disks can wear out. When tl1is happens, the spaces between the bones narrow. Bony out¬ growths called spurs (osteophytes) frequently form. When bone surfaces rub together, the joint and areas around the cartilage become inflamed and painful. Gradually your spine stiffens and loses flexibility. If several disks are involved, you may lose height.

Hips and knees are also frequently affected because they bear most of your weight. You can have chronic pain or varying amounts of dis¬comfort when you stand and walk. Swelling also may occur, especially in your knees.

Although it generally isn’t a seriously disabling condition, osteoarthritis won’t go away either. The acute pain of early osteoarthri¬tis often tends to fade with.in a year of its appearance, but it may return if you overuse the affected joint. Still, unless multiple joints are involved, the effects of osteoarthritis are unlikely to be disabling physically. And keeping fit helps prevent disability.

If a complete breakdown of cartilage occurs, the ends of the bones rub together and eventually become polished in a process Called “eburnation.” At this advanced stage, it will be difficult to use the joint.

If you think you may have osteoarthritis, schedule an appointment with your physician. Pain in either one or a few joints is a key to the diagnosis of osteoarthritis. Bone spurs and wearing down of cartilage may be evident in an X-ray of the affected joint, indicating the presence of osteoarthritis. The fact that osteoarthritis is so common is another clue that could explain your joint pain.

Changes of osteoarthritis occur in the cartilage before they are evident on an X-ray. Consequently, X-ray findings may be normal early on.

There is no blood test for osteoarthritis, but some blood tests and the appearance of the X-ray can help exclude rheumatoid and other forms of arthritis. The nature of the joint pain and the specific joints affected also help to distinguish these forms of arthritis.

Remember, the presence of osteoarthritis does not, in itself, indicate a problem. Many people have no symptoms or disability from their arthritis. Many are unaware they have osteoarthritis, having no appar¬ent discomfort.

Psoriatic Arthritis

Psoriatic Arthritis

Your hand and foot joints especially at risk in psoriatic arthritis, which is associated with psoriasis, a common skin disease. The synovial membrane becomes inflamed. The disease also affects tendons where they attach to bone.
Psoriatic arthritis affects men and women of all races and usually
occurs between the ages of 20 and 50, but can occur at any age.

Symptoms:

Around 95% of the people suffering with psoriatic arthritis have swelling in joints outside the spine and more than 80% of the sufferers have nail lesions. Other symptoms include:

• Swelling of toes/fingers that give a sausage look
• Silver or grey scaly spots on the scalp, knees and/or lower end of the spine, and elbows

Rheumatoid Arthritis

Rheumatoid Arthritis

Rheumatoid arthritis is not associated with the wear and tear of use or with an injury. The disease can strike at any time, but most often it develops between ages 20 and 50 years. An esti¬mated 2 million Americans have rheumatoid arthritis, and roughly twice as many women as men are affected.

Rheumatoid arthritis is probably an autoimmune disease. That’s a disease in which your body’s immune system attacks itself. Researchers suspect that an as yet unidentified agent, possibly a virus or a form of bacteria, stimulates the immune system to attack the invading agent. In autoimmune diseases, the cells usually engaged in fighting the invader become confused and instead attack your joints.

The principal area of attack of rheumatoid arthritis is the lining of the joint. When you have rheumatoid arthritis, white blood cells-whose normal job is to attack unwanted invaders-move from your blood¬stream into your synovial membrane. There, the blood cells appear to cause the membrane to become inflamed.
The inflammation results in thickening of the synovial membrane and a release of chemicals from synovial membrane cells and blood cells that have entered the membrane. If the inflammation persists, the released chemicals begin to digest cartilage, bone, tendons and ligaments in the joint. Gradually, the joint loses its shape and alignment. Ligaments, muscle and bone weaken. This weakening may lead to looseness in the joint. Eventually, the joint may be destroyed.

Rheumatoid arthritis often is more disabling than osteoarthritis. A painful, deformed joint may lead to loss of mobility and stability. Joints affected will be swollen, painful, tender and warm during the initial attack and during flare-ups that may follow.

Symptoms of rheumatoid arthritis include the following:

Pain and swelling in the smaller joints of your hands and feet

Overall aching or stiffness of the joints and muscles, especially after you sleep or after periods of rest

Loss of motion of the affected joints

Loss of strength in muscles attached to the affected joints

Deformity of the joints as time goes on

Fatig_e (severe during a flare-up) ¬

Even if stricken with a severe form of rheumatoid arthritis, you’ll probably retain flexibility in many joints. You may have less pain than the appearance of your deformed joints suggests. .

Joints often affected by rheumatoid arthritis are those in your wrists, hands, feet and ankles. The disease also can invade your elbows, shoul¬ders, hips, knees, neck and jaw. It generally affects joints on both sides of the body at the same time; for example, the knuckles of both hands. The most frequently involved joints are those of the hands and feet.

In rheumatoid arthritis, other symptoms can occur outside the joints. In contrast to osteoarthritis, which affects only your bones and muscles, rheumatoid arthritis can affect your whole body, including such organs as your heart, blood vessels, lungs and eyes. Rheumatoid arthritis causes problems in many joints at the same time, but osteoarthritis usu¬ally causes symptoms in only one or a few joints, even though several joints may be affected.

Small lumps, called rheumatoid nodules, may form under the skin of your elbow, your hands, the back of your scalp, over your knee or under your toes. These nodules range in size from that of a pea to perhaps a walnut. Usually the lumps aren’t painful.

If you have persistent discom¬fort and swelling in multiple joints on both sides of your body, your doctor will examine you and order laboratory tests. A blood test that determines your erythrocyte sedi¬mentation rate (or “sed rate”) can indicate the presence of an inflam¬matory process in your body. This rate is often abnormal in rheuma¬toid arthritis and tends to be nor¬mal in osteoarthritis. It may also increase due to anemia, which is often present in chronic rheumatoid arthritis. Another blood test looks for an antibody called rheumatoid factor. Four of five persons with rheumatoid arthritis have this abnor¬mal antibody, which is typically not present in persons with osteoarthri¬tis. There are typical X-ray changes of each condition which are differ¬ent in osteoarthritis and rheumatoid arthritis. A sequence of X-rays obtained over time can show the progression of arthritis.

Often, rheumatoid arthritis is chronic, although it tends to vary in severity and may even come and go. Periods of increased disease activi¬ty, called flare-ups or flares, alternate with periods of relative remission, during which the swelling, pain, difficulty in sleeping and weakness fade or disappear.

When first diagnosed, it’s impossible to predict how severe your rheumatoid arthritis may eventually be. If you have fairly continuous symptoms for 4 or 5 years your condition is more likely to pose a life¬time challenge. Periodic examination of your joints and tests such as the sedimentation rate test can be done to monitor your rheumatoid arthri¬tis. After 10 or 20 years the symptoms of inflammation, especially joint swelling, may stabilize, but joint deformities and some pain remain.

The cyclic nature of rheumatoid arthritis presents researchers with one of the most confusing aspects of the puzzle. Flares and remissions can occur for reasons that are unclear, occasionally leading people to seek, or credit, treatments of questionable merit.

There’s no cure for rheumatoid arthritis, but with proper treatment, a strategy of joint protection and changes in lifestyle, most people live long, productive lives after their arthritis develops. As with osteoarthri¬tis, both professional care and self-care are essential. Starting early in the disease on a carefully planned, individualized treatment program outlined by your physician and other health professionals offers the best chance of reducing the impact of the disease on your lifestyle.