| Arthritis
and musculoskeletal conditions are a major
cause of pain and disability, affecting around
6.1 million Australian and placing a high
economic and personal burden on the community.
However, effective treatment and management
can reduce the effects of these conditions.
There are more than 100 forms of arthritis
and musculoskeletal conditions, each having
different effects and requiring different
treatments.
Some of the more common forms of arthritis
are detailed below. Please click on the
title for more information. Arthritis NSW
has information and booklets on each of
these types of arthritis. Please contact
us if you would like us to send one to
you.
Rheumatoid
Arthritis (RA)
Arthritis is a broad term that covers over 100 conditions. Rheumatoid Arthritis
(RA) is one of them. Arthritis is derived from the two greek words arthron and
itis, which when translated literally mean joint inflammation.
Rheumatism is a general term used to describe
any pain in the musculoskeletal system.
Arthritis is inflammation of joints that
may result from injury, infection, errors
of metabolism or genetic predisposition. The first step in dealing with arthritis
is to understand the condition and the
factors that may cause it and/or aggravate
it.
Osteoarthritis is another very common
form of arthritis where the cartilage in
the joint becomes worn and inflamed causing
pain on movement.
RA and Osteoarthritis are two quite different
diseases with very different treatments
for each one. It is important not to confuse
the two.
If you have any doubt which type of arthritis
you have please discuss this with your
doctor as soon as possible because the
earlier treatment can begin with RA the
better the health outcome with less damage
to your joints.
RA is an inflammatory condition.
 The start of the disease
In most people RA starts quite slowly.
A few joints – often the fingers,
wrists or the balls of the feet – become
uncomfortable and may swell, often intermittently.
You may feel stiff when you wake up in
the morning. Many people only seek help
from the doctor when the symptoms become
more severe and frequent.
It is most
important to seek help from your doctor
early to allow for treatment to start
as soon as possible as it will improve
the inflammation and reduce the damage.
Rheumatoid Arthritis (RA) is an inflammatory
arthritis that occurs when the lining of
the joints, the synovium, becomes inflamed.
This inflammation causes the synovium to
thicken (pannus). Fluid is produced by
the joint lining, which causes swelling
and stiffness. The swollen red joint has
increased blood flow and may feel warm
to touch.
Our bodies normally produce inflammation
to destroy things, such as bacteria, which
cause illness. We do not know what sets
off the inflammation in the joints of someone
with RA but the result is the same – something
is attacked and perhaps destroyed. Unfortunately
in RA the tissues in the joints are attacked.
This eventually causes damage to the cartilage
and sometimes the bone itself. It may also
damage any ligaments within the joints.
IF YOU HAVE RHEUMATOID ARTHRITIS (RA)
TELEPHONE 1800 011 041 for your free
brochure which will answer your questions
and give you more information.
 Osteoarthritis
Osteoarthritis is the most common form of arthritis. People frequently see osteoarthritis
as being a progressive and disabling disease
Some people do experience symptoms of
severe pain and stiffness. But for many,
symptoms are mild and cause only temporary
and occasional problems.
Osteoarthritis is a condition involving
the breakdown of the protective cushion
of the cartilage covering the ends of the
bones where two bones meet to form a joint.
Current thinking is that osteoarthritis
is due to changes within the cartilage
cells which lead to a loss of elasticity.
Over a period of time, the cartilage thins
and may even break down leaving the bones
unprotected. As a result, the joint loses
its smooth functioning. The bone loses
shape and thickens at the end to produce
bony spurs called osteophytes.
 Juvenile Idiopathic
Arthritis (JIA)
Juvenile
idiopathic arthritis (JIA) is the umbrella
term for arthritis in childhood – idiopathic
means of unknown cause. There are five
different forms:
1. Systmeic Onset JIA
The young person can be very ill at the
onset with high, fluctuating temperatures
and a rash. These young people may require
hospitalisation to stabilise their condition.
2. Pauciarticular JIA, Monoarticular (one
joint) JIA and Oligoarthritis
These names essentially refer to the same
form of JIA. This is the most common form
of JIA involving four or fewer joints.
Commonly there is an associated eye condition,
which requires regular eye examinations
to prevent blindness.
- Extended Pauciarticular
JIA. After a time, more than four joints
are affected
3.
Polyarticular JIA – Rheumatid
Fcator Negative or positive (Do not or
do have Rheumatoid Factor antibodies)
Five or more joints are affected. The young
person may feel generally unwell. Rheumatoid
Factor positive form of JIA can be severe
but is less common than other forms and
the young person may be anaemic and experience
disease involvement of their internal organs.
4. Enthesitis related JIA
Inflammation and pain is experienced at
the point where tendon and other connecting
tissue join to bone, particularly lower
limbs and spine. Can affect eyes. Regular
eye examinations are required.
5. Psoriatic JIA
May affect several joints and the skin
condition psoriasis is also present.
Can affect eyes, regular eye examinations
are required.
Gout
Gout is one of the most common types of
arthritis and has symptoms such as inflammation
of the joint, swelling, warmth, redness
and pain. Due to advances in medical
research, gout can be well controlled
and if the correct treatment program
is followed, gout need not be a major
problem
Gout is a disease in which there is a
build-up of urate (uric acid) in the body.
A relatively small amount comes from the
food we eat. It is normally dissolved in
the bloodstream and passes out through
the kidneys. If the body cannot get rid
of enough, the urate will be deposited
in joints.
The first attack of gout usually involves
the big toe or “bunion joint”.
The ankle, foot and knee may also be affected.
It can occur over the point of the elbow,
occasionally in the hand and rarely in
other joints
Psoriatic
Arthritis (PsA)
Psoriatic Arthritis (PsA) is part of a larger
group of disorders called spondyloarthritis
(pronounced ‘spon-dill-oh’ arthritis).
Psoriatic arthritis (pronounced ‘sore-attic’ arthritis)
is an inflammatory type of arthritis that
causes pain and swelling in some joints,
scaly patches on some areas of the skin
and thickening and pitting of the fingernails
and toenails.
Psoriatic arthritis may have a big impact
on your day-to-day life, but there are
many things you can do to help you cope,
take control and minimise its impact on
you.
Psoriatic arthritis is an inflammatory condition
Inflammation is a process the body uses
to protect itself from infection and
damage. Your immune system is acting
to protect your body from invasion by
germs, and is also repairing damage.
But sometimes your body’s inflammatory
response does not work exactly the way
it should. Instead of protecting your tissues
and organs, your immune system sets up
inflammation when it’s not needed.
This is what happens in your joints and
skin if you have psoriatic arthritis.
The start of the disease
In most people PsA starts quite slowly.
Some people may see inflammation in their
skin first or inflammation in their joints
first.
In your joints the tissue becomes inflamed.
This can lead to pain, swelling and stiffness.
Over time, the muscles, ligaments and cartilage
around the bone, and the bones themselves,
can become inflamed and damaged.
In your skin, inflammation causes raised,
red, flaky and often itchy patches to appear.
This is psoriasis. The patches are called
plaques and are often, but not always,
found over the joints of the fingers, toes
and lower back.
You cannot ‘catch’ psoriasis
or psoriatic arthritis.
IF YOU HAVE PSORIATIC ARTHRITIS TELEPHONE
1800 011 041 for your free brochure which
will answer your questions and give you
more information.
Ankylosing
Spondylitis (AS)
Ankylosing spondylitis (or AS for short)
is a chronic rheumatic condition that
mainly affects the back and neck. The
term ankylosing spondylitis is derived
from the Greek language and is pronounced ‘Ank-ill-ose-ing
Spon-dill-eye-tis’.
Ankylosing means stiffening or joining
together and is used to describe the fusion
of bones in the spine. Spondylitis means
inflammation of the spine, a characteristic
feature of AS.
Is ankylosing spondylitis the same as spondylosis?
No. The term spondylosis is used to describe
degenerative changes of the spine and is
more common in older people. This is unlike
AS which is an inflammatory condition,
without degenerative changes, which can
produce overgrowth of bone and can lead
to fusion (joining) of vertebrae (bones
that make up the spine).
AS is an inflammatory condition
In AS, inflammation commonly occurs where
ligaments or tendons attach to bone (this
is called an enthesis). Ligaments are
made of fibrous tissue that connects
bone to bone while tendons connect muscles
to bone.
In the early stages of AS most of the
pain and stiffness is caused by inflammation.
Over time, the process of spinal inflammation
and associated tissue damage may lead to
bony overgrowths (called syndesmophytes,
pronounced ‘sin-de-moe-fye-tees’)
which extend from the edge of one vertebra
to the next. This process may lead to ankylosis
or fusion of part of the spine and sometimes
the pelvis. Over time, the elasticity of
the ligaments and tendons may be replaced
by rigid fused bone, and flexible movement
of the spine may become increasingly restricted.
Related disorders
AS is part of a larger group of disorders
called spondyloarthritis (pronounced ‘spon-dill-oh’ arthritis)
which also includes:
•
Psoriatic arthritis (pronounced ‘sore-attic’ arthritis)
- this arthritis usually occurs with psoriasis
(pronounced ‘sore-eye-a-sis’).
Psoriasis is a scaly skin disorder characterised
by scattered red patches covered with white
scales.
•
Reactive arthritis - this is an acute arthritis
that is triggered by certain bowel and
genital infections such as Salmonella or
Chlamydia.
•
Arthritis with inflammatory bowel disease
- arthritis can sometimes occur in inflammatory
bowel disease such as Crohn’s disease
and ulcerative colitis.
•
Undifferentiated spondyloarthritis - this
usually presents with symptoms of AS without
the characteristic x-ray changes in the
sacroiliac joints. Over time, most individuals
with undifferentiated spondyloarthritis
will develop ankylosing spondylitis.
IF YOU HAVE ANKYLOSING SPONDYLITIS TELEPHONE
1800 011 041 for your free brochure which
will answer your questions and give you
more information.
Fibromyalgia
Fibromyalgia is a type of Rheumatism which
affects the muscles and ligaments but not
the joints. Because there are no outward
signs, the pain and suffering experienced
is not visible.
It is a common condition, sometimes so
severe that it interferes with personal
and family life. In fibromyalgia the fibrous
tissues and muscles are affected by pain
and tenderness. The pain may often feel
as though it affects the whole body.
Tender points are usually present in certain
parts of the body which helps the doctor
make a diagnosis. If pressure is applied
to these tender points most people will
find it uncomfortable, but in fibromyalgia
there is a change in the threshold at which
pressure causes pain and many of these
points can be extremely tender.
In the past fibromyalgia was diagnosed
as muscular rheumatism or fibrositis, or
else it was diagnosed as degenerative disease
of the joints. However research in the
last few years has led to a much clearer
picture of fibromyalgia and the diagnosis
is being made more often by Rheumatologists
and General Practitioners.
(Source: Arthritis and Rheumatism Council
for Research: A booklet for patients)
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