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Like many English words describing medical conditions, the word ‘arthritis’ comes from the Greek language: arthro means joint and itis means inflammation. There are more than 100 different types of arthritis, including osteoarthritis, rheumatoid arthritis and gout. Arthritis is a major cause of morbidity and significantly influences the health and quality of life of millions of people around the world. Approximately 40% of people over 70 years old suffer from osteoarthritis of the knee and 80% of people with osteoarthritis have some limitation of movement, including 25% that cannot perform major daily life activities¹. In more than 50% of rheumatoid arthritis cases, the disease leads to the inability to work within ten years of onset².

The most common type of arthritis is osteoarthritis, which occurs when the cartilage covering the end of the bones gradually wears away. Osteoarthritis is sometimes called degenerative joint disease because it often occurs as the cartilage degenerates, or breaks down. The joints most commonly affected include the hips, knees and spine, all of which are weight bearing joints. The fingers, neck and large toe can also be affected³. Heredity (an inherited defect in one of the genes that makes cartilage, leading to more rapid deterioration of joints), obesity, injury and joint overuse may increase a person’s risk of developing osteoarthritis⁴. The disease is usually treated by medication (e.g., pain-relievers such as acetaminophen and anti-inflammatory drugs, creams, steroids), exercise, hot and cold compresses to the painful joint, the use of supportive devices such as canes, and weight loss. When other treatment options have not been effective, surgery may be performed to relieve pain⁵.

Rheumatoid arthritis, an autoimmune disease, occurs when immune cells migrate from the blood into the joints and produce substances that cause inflammation. This results in joint irritation, causing the cartilage to wear down, and the joint lining (synovium) to swell and produce fluid⁶. The joints become very painful, swollen and warm to the touch. Rheumatoid arthritis occurs in joints on both sides of the body; its symmetrical nature is one distinguishing factor from other types of arthritis. It occurs most commonly in the hands, wrists and knees. In rheumatoid arthritis, something seems to trigger the immune system to attack the joints. The exact cause is unknown, but a combination of genetic, environmental and hormonal factors are thought to play a role⁷. Treatments include medications (e.g., anti-inflammatory drugs and disease-modifying anti-rheumatic drugs that interfere with or suppress the immune system’s attack on the joints), rest and exercise, and surgery to correct joint damage⁸.

Gout, another common type of arthritis, occurs when the body cannot eliminate uric acid, a natural substance produced during the breakdown of RNA and DNA in cells. Foods such as red meats, organ meats (e.g., liver, kidney) and anchovies contain large amounts of uric acid. It usually dissolves in the blood, passes through the kidneys and leaves the body. Gout occurs when excess uric acid forms needle-like crystals in the joints, causing sudden, severe pain and tenderness, as well as swelling. It most often affects the big toe, knee and wrist joints⁹. Since heredity partly determines the kidney’s ability to rid the body of uric acid, not everyone with high levels of uric acid will develop gout. Symptoms can often be treated and controlled, but there is no cure for gout. Treatments include NSAIDs (non-steroidal anti-inflammatory drugs), corticosteroids and colchicine¹⁰.

Discussion questions

1. Please summarize the article. What is the main point of the article?
2. Who is affected by arthritis?
3. What causes osteoarthritis?
4. What is rheumatoid arthritis?
5. What is gout?
6. Please describe the treatments for the types of arthritis in this article.
7. How can the risk of developing arthritis be reduced?

References:

1. World Health Organization Scientific Group. The burden of musculoskeletal conditions at the start of the new millennium. World Health Organization. 2003.　Accessed 22 September 2006.
2. World Health Organization Scientific Group. The burden of musculoskeletal conditions at the start of the new millennium. World Health Organization. 2003.　Accessed 22 September 2006.
3. Arthritis: Arthritis basics. WebMD.　Accessed 22 September 2006.
4. Arthritis: Osteoarthritis basics. WebMD.　Accessed 22 September 2006.
5. Arthritis: Osteoarthritis basics. WebMD.　Accessed 22 September 2006.
6. Arthritis: Rheumatoid arthritis basics. WebMD.　Accessed 22 September 2006.
7. Arthritis: Rheumatoid arthritis basics.　Accessed 22 September 2006.
8. Arthritis: Rheumatoid arthritis basics.　Accessed 22 September 2006.
9. Arthritis: Gout basics. WebMD.　Accessed 22 September 2006.
10. Arthritis: Gout basics. WebMD.　Accessed 22 September 2006.
11. [xi]Arthritis: Arthritis basics. WebMD.　Accessed 22 September 2006.