Arthritis is poorly understood by most of the people. People share this misconception that Arthritis is an old-age disease and effects only elderly people. Arthritis is commonly seen in older people but it can also develop in children, teens and in young people.
There are more than 100 different types of rheumatic diseases which cause arthritis and can affect anyone from a child to an old person. Although the risk of developing arthritis increases with age but about two- thirds of people with arthritis are younger than 65 years. Females are affected more than males. Millions of people get affected by this disease annually in India.
It is impossible to discuss all types and common causes of arthritis except few known ones.
Arthritis is inflammation in and around joints. It is a rheumatic condition. Symptoms include pain, stiffness and swelling in and around joints. Two common forms are osteoarthritis (OA) and Rheumatoid Arthritis (RA). The other forms are Psoriatic arthritis, Ankylosing Spondylitis, Arthritis caused by Connective Tissue Disorder such as Systemic Lupus Erythematosus , mixed connective tissue disorder, undifferentiated connective tissue disorder, Fibromyalgia and Gout. Among children up to 16 years it is Juvenile Idiopathic Arthritis.
It is a common joint disease that most often affects middle-age and elderly people and is a degenerative disease. This type of arthritis mostly affects knees but it can also develop in hip, hands, spine and toes. Unlike other forms of arthritis, it only affects joints and not internal organs. It usually sets mechanical type of pain which becomes worst with activity. There is stiffness in the affected joint after sitting for longer periods called “Gelling phenomena”. Sometimes a crunching feeling or rubbing on bone sound is felt. There is no single test to diagnose it. The diagnosis is made after ruling out other causes affecting joints.
The second common form is Rheumatoid Arthritis. In all populations, women are affected approximately three times more than men. It effects about 1-3 percent of population. Peak onset age (80 percent of cases) is between 35 and 50 years. About 50 percent of patients have gradual onset whereas a sudden onset is much less common (10 to 25 percent).
It is a chronic progressive systemic inflammatory disorder in which joints are the primary target, particularly small joints of hands and feet on both side of body and can involve other systems of the body too. Less common is a slow mono-articular process affecting larger joints such as
shoulders or knees. The symptoms may remain confined to one or two joints but frequently spreads over in the ensuing days and weeks additively to affect wrists, fingers, ankles, or feet in a widespread fashion. It develops in course of weeks to months. Arthritis is often accompanied by prolonged morning stiffness lasting an hour or more. Many patients have symptoms like, fatigue, malaise, decreased appetite and low grade fever. Joint destruction and deformities are most common complications. These changes can substantially impair patient’s mobility and ability to perform daily activities.
It is a male dominated arthritis having strong genetic component, the peak onset is between 15 and 30 years. Onset is rare after age 50. It can also affect a child between the ages of 8 and 16. It belongs to the group of arthritis known as Spondyloarthritis
Symptoms often begin in younger age. It usually affects the spine in majority of cases but other peripheral joints such as hands, wrists, knees, hips and ankle can also get involved. Arthritis is asymmetrical as compared to Rheumatoid Arthritis where it is symmetrical. Patients usually complain about pain and prolonged stiffness that may only be relieved by anti-inflammatory medication and increased activity. Eye involvement is seen in 40 percent of patients having HLA B27 positive.
It also a member of Spondyloarthritis. Some 8 to 45 percent of people who have skin psoriasis may develop Psoriatic Arthritis. The mean age of onset is 30 to 55 years and it affects both genders equally.
It has an insidious onset and progressive course. Peripheral arthritis may present either in asymmetric as in Ankylosing Spondylitis or may be symmetrical making them indistinguishable from Rheumatoid Arthritis. Spine is also involved in it.
Connective Tissue disorders
These are another group of diseases causing arthritis, affecting mainly females. The highest incidence ranges from 20 to 50 years. Joint pains are pretty common in 90 percent and may show initial presentation. Arthritis is polyarticular involving hands, wrists, knees and ankles and can be deforming. Morning stiffness is also present.
It is the most common cause of metabolic/inflammatory arthritis in men aged more than 50 years, though in certain cases it can occur in young males too. It is rare in children, young females and peri-menopausal women. Of the gout patients above the age of 60 years, 50 percent are women.
It usually affects the big toe and ankle joint, the other joints of feet, hand wrist and elbow can be involved too.
Juvenile Idiopathic Arthritis - (Childhood Arthritis)
It is universal and constitutes 2.7 percent to 5 percent of all Rheumatoid Arthritis with its onset before 15 years. It peaks between 1 to 3 years of age in females, whereas in males it is bimodal with the peak onset in 2 years and second between 8 and 10 years. Child may have overt symptoms like decreased ability to run, limping complaints of pain and or swelling often worse in the morning making difficult to get up from bed.
While there’s no cure for arthritis, some can lead normal life if diagnosed at appropriate time.