How does arthritis differ from arthrosis?
The difference is fundamental and determines everything that follows. With arthrosis, pain appears during exercise and in the evening, decreases with rest, stiffness is short - a few minutes after the start of movement, and there is usually no pronounced swelling and redness. With arthritis, pain bothers you at rest and at night, morning stiffness lasts from half an hour or longer, the joint swells, and the skin over it may be warmer and redder. Arthrosis most often affects large loaded joints and joints of the hands in the elderly; arthritis can begin at any age, including in children, and often affects several joints symmetrically.
- Arthritis - pain at rest and at night, arthrosis - with exercise
- Morning stiffness due to arthritis lasts 30 minutes
- Swelling, warmth and redness are characteristic of arthritis
- Arthritis can start at any age
- In arthritis, ESR and C-reactive protein are often elevated
Main types
Rheumatoid arthritis is an autoimmune disease with symmetrical damage to the small joints of the hands and feet and severe morning stiffness. Gout manifests itself as sudden attacks of severe pain, often in the joint of the big toe, against the background of increased uric acid. Reactive arthritis develops several weeks after an intestinal or urogenital infection. Psoriatic occurs in people with psoriasis and can affect the entire fingers. Infectious, or septic, arthritis is an emergency: the pathogen gets directly into the joint, and without prompt treatment, the cartilage is destroyed in a matter of days.
- Rheumatoid arthritis - symmetrical, small joints
- Gouty - attacks, often the big toe
- Reactive - after an intestinal or genital infection
- Psoriatic - against the background of psoriasis
- Septic - acute, with fever, requires emergency care
- Juvenile idiopathic arthritis in children
- Arthritis in systemic connective tissue diseases
Symptoms
The classic presentation includes pain, swelling, limitation of movement, and morning stiffness. It is important to pay attention to details that will tell the doctor the shape: how many joints are involved, whether they are symmetrical, whether they are large or small joints, how quickly it all started. General manifestations - fatigue, low-grade fever, loss of appetite and weight - often accompany autoimmune forms and indicate a systemic process. Associated signs outside the joints, such as psoriatic plaques, eye inflammation, rashes, mouth ulcers or intestinal lesions, serve as important diagnostic clues.
- Joint pain at rest and at night
- Swelling and enlargement of the joint
- Morning stiffness from 30 minutes
- Redness and local fever
- Limited mobility
- Weakness, fatigue, low-grade fever
- Extra-articular manifestations: skin, eyes, intestines
Diagnostics
The doctor clarifies which joints are involved and how it all started, examines them and assesses the range of motion. In the laboratory, indicators of inflammation are determined - ESR and C-reactive protein, as well as specific markers: rheumatoid factor and antibodies to cyclic citrullinated peptide for suspected rheumatoid arthritis, uric acid for suspected gout, antinuclear antibodies for systemic diseases. Ultrasound reveals effusion and inflammation of the synovium before x-rays, and x-rays show bone changes that have already occurred. In acute inflammation of one joint, puncture with examination of the joint fluid is crucial.
- Complete blood count with ESR
- C-reactive protein
- Rheumatoid factor and ACCP
- Uric acid
- Antinuclear antibodies
- Ultrasound of joints
- X-ray of affected joints
- Joint puncture with fluid analysis for acute arthritis
Treatment and lifestyle
Treatment is always aimed at a specific form. To quickly reduce pain and inflammation, non-steroidal anti-inflammatory drugs are used, and, if necessary, glucocorticosteroids, including intra-articular ones. But the key role in autoimmune arthritis is played by basic therapy, which is prescribed by a rheumatologist: it slows down the destruction of joints, and it needs to be started as early as possible. In case of gout, the level of uric acid is reduced; in case of reactive arthritis, the infection that caused it is treated; in case of septic arthritis, the joint is urgently drained and antibiotics are prescribed. Movement is necessary: feasible physical therapy preserves mobility, while complete rest leads to stiffness. Losing weight and quitting smoking are also important.
- Nonsteroidal anti-inflammatory drugs
- Short course glucocorticosteroids as prescribed
- Basic therapy for autoimmune forms
- Reducing uric acid in gout
- Antibiotics for infectious arthritis
- Physical therapy and maintaining mobility
- Losing weight and quitting smoking
- Regular monitoring of tests during therapy