Arthritis&Arthrosis

Arthirtis

Arthritis (from Greek arthro-, joint, and -itis, inflammation) is a group of conditions where there is damage caused to the joints of the body. Arthritis is the leading cause of disability in people over the age of 55.

According to Arthritis Foundation the word “arthritis” is referred to more than 100 different diseases that cause pain, swelling, and impaired motion. Generally, it's a chronic disease, i.e. it lasts for the whole life.

All arthritides feature pain. Patterns of pain differ among the arthritides and the location. Osteoarthritis is classically worse at night or following rest. Rheumatoid arthritis is generally worse in the morning; in the early stages, patients often do not have symptoms following their morning shower. In elderly people and children, pain may not be the main feature, and the patient simply moves less (elderly) or refuses to use the affected limb (children).

Many people associate cracking joints with arthritis; however, there is no evidence to support such an association. A joint is an area where two or more bones meet. This area is surrounded by joint fluid to protect the bones from rubbing against each other. When a joint is cracking, the fluid is pushed out and the "cracking" sound is the result of a high pressure of fluid. Rheumatoid arthritis is what happens when there is a loss of fluid in the joints causing damage to the lining of the joint itself. There is no evidence that cracking your knuckles causes such damage.

Each form of arthritis has a different cause. Rheumatoid arthritis and psoriatic arthritis are autoimmune diseases in which the body is attacking itself. Septic arthritis is caused by joint infection. Gouty arthritis is caused by deposition of uric acid crystals in the joint that results in subsequent inflammation. Additionally, there is a less common form of gout that is caused by the formation of needle shaped crystals of calcium pyrophosphate. This form of gout is known as pseudogout. The most common form of arthritis, osteoarthritis is also known as degenerative joint disease and occurs following trauma to the joint, following an infection of the joint or simply as a result of aging. There is emerging evidence that abnormal anatomy may contribute to early development of osteoarthritis.

Usually, traditional treatments of arthritis call for a suppression of inflammatory condition with anti-inflammatory and analgetic drugs, and as last chance with surgery.
Several are the natural remedies based on the idea that the main step in arthritis treatment is restoring immune system's proper functions. The main natural remedies adjuvants to arthritis treatments call for nutritional supplementation with antioxidants (such as vitamin C and E, beta-carotene, green tea, and vine seeds extracts) which protect joints from decay; essential fatty acids; cetyl myristoleate (CMO) which has immunomodulant properties; glucosamine and chondroitin sulfate (that is the main cartilage components); sea cucumber with its anti-inflammatory action; methylsulfonylmethane (MSM) that seems having a pain-relieving and anti-inflammatory properties; some herbs with documented anti-inflammatory and pain-relieving properties (such as cat's claw, boswella, ginger, urtica dioica, devil's claw); and zinc, copper, and manganese. Additionally, creams with capsaicine or eucalyptus oil applied directly on affected area may be helpful to soothe the pain.

Following-up a brief summary of the main forms of arthritis.

Primary forms of arthritis

Osteoarthritis:	Also known as degenerative arthritis or degenerative joint disease (and sometimes referred to as "arthrosis"* or "osteoarthrosis" or in more colloquial terms "wear and tear"), it's a condition in which low-grade inflammation results in pain in the joints, caused by wearing of the cartilage that covers and acts as a cushion inside joints. This leads to an impairement of muscles, tendons, and ligaments that support joint. The consequent effort of the body to steady the joint leads to bone spurs and osteophyte formation. This process can be sped up by overweight condition, joint injuries, deficient diet, and/or scanty workout.
Rheumatoid Arthritis:	It is traditionally considered a chronic, inflammatory autoimmune disorder that causes the immune system to attack the joints. RA is a systemic disease, often affecting extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and muscles. RA doesn't cause just pain, but also anemia, fatigue, weight loss, fever, and disability. RA can be due to genetic proneness, life styles, diet, food allergies, and micro-organisms (such as viruses and bacteria). One of the most recent theories assumes that an impaired permeability of intestinal walls enables undigested foods to completely go in blood flow. So that, these thicker particles in blood flow lead to an immune disorder that cause immune system to attack tissues surrounding joint.
Septic Arthritis:	Septic arthritis is the invasion of the joint space by an infectious agent. The usual etiology is bacterial, but viral, mycobacterial, and fungal arthritis can also occasionally occur. Bacteria are either carried by the bloodstream from an infectious focus elsewhere, introduced by a skin lesion that penetrates the joint, or by extension from adjacent tissue
Fibromyalgia:	It's a condition of unknown origin featured by chronic and general muscle pain, joint pain, stiffness, asthenia, paresthesias, insomnia, anxiety, and irritable bowel syndrome. It occurs more often in women between the ages of 20 and 50.
Gout and Pseudogout:	Gout, also called metabolic arthritis, is a disease due to a congenital disorder of the uric acid metabolism. In this condition monosodium urate crystals are deposited on the articular cartilage of joints and in particular tissues like tendons. This provokes an inflammatory reaction of these tissues. These deposits often increase in size and burst through the skin to form sinuses discharging a chalky white material.Calcium pyrophosphate deposition disease (CPPD) is a rheumatologic disorder with varied clinical manifestations due to precipitation of calcium pyrophosphate dihydrate crystals in the connective tissues. It is more commonly known by alternative names that specify certain clinical or radiographic findings, although neither is synonymous with CPPD. Pseudogout refers to the clinically evident acute synovitis with red, tender, and swollen joints that may resemble gouty arthritis (a similar condition with joint deposition of monosodium urate crystals). Chondrocalcinosis, on the other hand, refers to the radiographic evidence of calcification in hyaline and/or fibrocartilage. Pyrophosphate arthropathy is a term that may refer to either of the above, but is uncommonly used.
Juvenile Arthritis:	Juvenile idiopathic arthritis (JIA), formerly known as juvenile rheumatoid arthritis (JRA), is the most common form of persistent arthritis in children. JIA is sometimes referred to as juvenile chronic arthritis (JCA),a term that is not precise as JIA does not encompass all forms of chronic childhood arthritis.Arthritis is the inflammation of the synovium (the lining tissues) of a joint. JIA is a subset of arthritis seen in childhood, which may be transient and self-limited or chronic.
Still's Disease:	Still's disease is a form of juvenile idiopathic arthritis, characterized by high spiking fevers and transient rashes. The disease was first discovered in children, but now it is also known to occur, less commonly, in adults.
Ankylosing Spondylitis:	Ankylosing spondylitis (AS; also known as Bechterew's disease; Bechterew syndrome; Marie Strümpell disease / Marie Struempell disease / Spondyloarthritis) is a chronic, painful, progressive inflammatory arthritis primarily affecting spine and sacroiliac joints, causing eventual fusion of the spine; it is a member of the group of the autoimmune spondyloarthropathies with a probable genetic predisposition. Complete fusion results in a complete rigidity of the spine, a condition known as bamboo spine.

Secondary to other diseases

Systemic Lupus Erythematosus (SLE):	Systemic lupus erythematosus (SLE or lupus) is a chronic autoimmune disease that is potentially debilitating and sometimes fatal as the immune system attacks the body’s cells and tissue, resulting in inflammation and tissue damage. SLE can affect any part of the body, but most often harms the heart, joints, skin, lungs, blood vessels, liver, kidneys and nervous system. The course of the disease is unpredictable, with periods of illness (called flares) alternating with remission. Lupus can occur at any age, but is most common in women, particularly of non-European descent. The origins of the name are uncertain, but may derive from a characteristic reddish rash that purportedly resembles a wolf's face.
Henoch-Schönlein Purpura:	Henoch-Schönlein purpura (HSP, also known as allergic purpura) is a systemic vasculitis characterized by prominent tissue deposition of IgA-containing immune complexes, especially in the skin and kidney. It has a prominent cutaneous involvement similarly seen in mixed cryoglobulinemia and hypersensitivity vasculitis: palpable petechiae or purpura is a major finding in these disorders. The pathogenesis is similar to that of IgA nephropathy, with similar histologic findings in the kidney.
Psoriatic Arthritis:	It is a type of inflammatory arthritis that affects around 20% of people suffering from the chronic skin condition psoriasis. Treatment of psoriatic arthritis is similar to that of rheumatoid arthritis. More than 80% of patients with psoriatic arthritis will have psoriatic nail lesions characterised by pitting of the nails, or more extremely, loss of the nail itself (onycholysis). Psoriatic arthritis is said to be a seronegative spondyloarthropathy. Psoriatic arthritis can develop at any age, however on average it tends to appear about 10 years after the first signs of psoriasis. For the majority of people this is between the ages of 30 and 50, but it can also affect children. Men and women are equally affected by this condition. In about one in seven cases the arthritis symptoms may occur before any skin involvement. As well as causing joint inflammation, psoriatic arthritis can cause tendonitis and a sausage-like swelling of the digits known as dactilytis. Radiology will give the appearance of "fluffy, new" bone.
Reactive Arthritis (Reiter's syndrome):	Reactive arthritis (ReA) is an autoimmune condition that develops in response to an infection in another part of your body. Coming into contact with bacteria and developing an infection can trigger reactive arthritis. Reactive arthritis has symptoms similar to arthritis or rheumatism. It is caused by another disease, and is thus "reactive", i.e., dependent on the other condition. The "trigger" infection is typically missing in the chronic case. Reactive arthritis is the combination of three seemingly unlinked symptoms—an inflammatory arthritis of large joints, inflammation of the eyes (conjunctivitis and uveitis), and urethritis. It is also known as arthritis urethritica, venereal arthritis, seronegative spondyloarthropathy, polyarteritis enterica.
Hemochromatosis:	Also spelled hemochromatosis, it is a hereditary disease characterized by improper processing by the body of dietary iron which causes iron to accumulate in a number of body tissues, eventually causing organ dysfunction. It is the most common iron overload disorder.
Hepatitis:	Hepatitis implies injury to liver characterised by presence of inflammatory cells in the liver tissue. The condition can be self limiting, healing on its own or can progress to scarring of liver. Acute hepatitis is when it lasts less then 6 months and chronic hepatitis is when it persists longer. A group of viruses known as the hepatitis viruses cause most liver damages worldwide. Hepatitis can also be due to toxins (notably alcohol), other infections or from autoimmune process. It may run a subclinical course when the affected person may not feel ill. The patient becomes unwell and symptomatic when the disease impairs liver functions that include among other things, screening of harmful substances, regulation of blood composition and production of bile to help digestion.
Wegener's granulomatosis (and many other vasculitis syndromes):	Wegener's granulomatosis is a form of vasculitis that affects the lungs, kidneys and other organs. It is part of a larger group of vasculitic syndromes that all feature the presence for an abnormal type of circulating antibody termed ANCAs (antineutrophil cytoplasmic antibodies) and affect small and medium-sized blood vessels. Apart from Wegener's, it includes Churg-Strauss syndrome and microscopic polyangiitis.
Inflammatory Bowel Disease (Including Crohn's Disease and Ulcerative Colitis):	Inflammatory bowel disease (IBD) is a group of inflammatory conditions of the large intestine and, in some cases, the small intestine. It should not be confused with IBS, irritable bowel syndrome, which is less severe. Chron (also known as regional enteritis) is a chronic, episodic, inflammatory condition of the gastrointestinal tract characterized by transmural inflammation (affecting the entire wall of the involved bowel) and skip lesions (areas of inflammation with areas of normal lining in between). Crohn's disease is a type of inflammatory bowel disease (IBD) and may sometimes affect any part of the gastrointestinal tract from mouth to anus; as a result, the symptoms of Crohn's disease can vary between affected individuals. The main gastrointestinal symptoms are abdominal pain, diarrhea (which may be bloody), and weight loss. Crohn's disease can also cause complications outside of the gastrointestinal tract such as skin rashes, arthritis, and inflammation of the eye. Ulcerative colitis (Colitis ulcerosa, UC) is a form of inflammatory bowel disease (IBD). Ulcerative colitis is a form of colitis, a disease of the intestine, specifically the large intestine or colon, that includes characteristic ulcers, or open sores, in the colon. The main symptom of active disease is usually diarrhea mixed with blood, of gradual onset. Ulcerative colitis is, however, a systemic disease that affects many parts of the body outside the intestine.
Familial Mediterranean Fever (FMF), HIDS (hyperimmunoglobulinemia D and periodic fever syndrome) and TRAPS (TNF-alpha receptor associated periodic fever syndrome):	Familial Mediterranean fever (FMF) is a hereditary inflammatory disorder that affects groups of patients originating from around the Mediterranean Sea (hence its name). Its symptoms include fever, abdominal and chest pain, and an erythema on ankles that impairs joints.

Arthrosis*

Arthrosis (also known as osteoarthrosis) is a jojnt disease that mainly affects vertebral column and knees cartilage and causes degenerative injuries to cartilage (or osteophytes). It differs from arthritis, which is a inflammatory disease, 'cos it's a degenerative process. At the beginning, it shows joints injuries (such as the loss of cartilage that covers joint head) due to either overloaded or enzymes actions that attack cartilage. Chondrocytes (i.e. cartilage cells) decrease, and drifts originated by tissue degeneration lead to an inflammation that further on impairs cartilage leading to its total vanishing. It happens a modification in surrounding bone tissue such as generation of osteophytes (abnormal bone papillas), dystrophy, and others.
Arthrosis can be localized or generalized. When it's localized, it usually depends by specific problems of the affected area, such as injuries or deformities; when it's generalized, it's due to several causes not all known, such as tissue aging, endocrine alteration, overloaded joint (in obesity or metabolic impairement cases).
It usually affects elderly people (the 80% of patients are over the age of 65), but it can struck even younger people.
At the beginning, arthrosis features mild pain, more often before and following rest time. This pain is due either to synovial membrane of articular capsule inflammation, ligament and articular capsule sprain, bone micro-fracture, or others. Symptoms get worse with disease progression that at further stages leads to continual pain and reduced or inhibited mobility.
The treatments depends by the specific joint affected and disease stage. Traditional treatments calls for anti-inflammatory and analgetic drugs(in earlier stages), or surgery that substitues the damage joint with a prosthesis (in the most severe stages). Nowadays, it's becoming clear that is crucial to help preventing this disease by taking dietary supplements of antioxidants, glucosamine, and/or hyaluronic acid.

Arthrosis can be:

• Primary, when it's due to genetic factors. It features Heberden's nodes.
• Secondary, when it's due to injuries, surgery, or rheumatic disease.
• Professional, it's a kind of secondary arthrosis due to prolonged and extensively use of some joints.

The most frequent types of arthrosis are:

• Gonarthrosis, i.e. knee arthrosis
• Rizarthrosis, i.e. thumb joint arthrosis
• Coxarthrosis, i.e. hip arthrosis
• Spondylarthrosis, i.e. vertebral joints arthrosis

 



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