Arthritis is a disease that causes pain and loss of motion in joints. Pain is referred to as arthralgia. Arthritis is the leading cause of disability in people over 55 years. The causes of arthritis depend on the form of arthritis. The causes are injuries (as osteoarthritis), abnormal metabolism (such as gout and pseudogout), inheritance, infections, and for unclear reasons (such as rheumatoid arthritis and systemic lupus erythematosus). There are many forms of arthritis. There are about 200 different types of arthritis. The most common type is osteoarthritis (or degenerative arthritis), where the cartilage that protects the bones wears away. This makes the joints stiff, painful and fragile. About 5 million people in the UK have osteoarthritis. OA is a chronic degenerative arthropathy that frequently leads to chronic pain and disability. With our aging population, this disease is becoming increasingly common and its treatment increasingly financially burdensome. The use of radiological criteria, distal and proximal interphalangeal joints of the hand have been identified as the joints most commonly affected by OA, but are less likely to be symptomatic. Age is the major identified risk factor for OA, regardless of the joint under study. Prevalence rates for both radiographic OA and, to a lesser extent, symptomatic OA rise significantly after age 50 in men and age 40 in women. Occupation-related repetitive injury and physical trauma contribute to the development of secondary (non-idiopathic) OA, sometimes occurring in joints that are not affected by primary (idiopathic) OA, the metacarpophalangeal joints, wrists and ankles.

Rheumatoid arthritis (RA) is traditionally considered a chronic, inflammatory autoimmune disorder. Rheumatoid arthritis occurs when the body defense mechanisms go into action when there is no threat and start attacking the joints and sometimes other body parts. RA affects 2.1 million Americans, or about 1% of adults in the United States. This disease is 2 to 3 times more common in women than in men and usually affects people aged between 20 and 50. However, young children may develop a form of RA called juvenile rheumatoid arthritis. Two of the 100 types of arthritis are rheumatoid arthritis and lupus. There are specific symptoms, distinguishing characteristics, as well as the overlap of symptoms associated with rheumatoid arthritis and lupus. Rheumatoid arthritis is an additive polyarthritis, with the sequential addition of involved joints, in contrast to migration or evanescent arthritis of systemic lupus erythematosus or the episodic arthritis of gout. Occasionally, patients experience an explosive polyarticular start occurring over 24 to 48 hours. Morning stiffness, persisting more than an hour, but often for several hours can be a feature of any inflammatory arthritis but is especially characteristic of rheumatoid arthritis. Its duration is a useful indicator of inflammatory activity of the disease.

Psoriatic arthritis is related to the skin condition psoriasis. It occurs more frequently in patients with tissue type HLA-B27. There are five clinical patterns of psoriatic arthritis. First is asymmetric mono-and oligoarticular arthritis (30-50% of cases) is the most common presentation of psoriatic arthritis. Second is symmetrical polyarticular arthritis (30-50% of cases) is ultimately the most common form of psoriatic arthritis. Third, distal interphalangeal (DIP) joint involvement (25% of cases) is almost always associated with nail manifestationsm. Fourth is arthritis affects mutilans is less than 5% of patients and is a gross distortion and destructive arthritis. This condition can progress over months or years causing severe joint damage. Fifth is the axial arthritis (30-35% of cases) may be different in character from ankylosing spondylitis, the prototype of HLA-B27 associated spondyloarthropathy. It may present as sacro-iliitis, which can be asymmetrical and asymptomatic, or spondylitis, which can occur without sacro-iliitis and can affect any level of the column to “jump” out of fashion. Genetic factors appear to play an important role. There is a 70% concordance for psoriasis in monozygotic twins. There is a 50 times greater risk of developing psoriatic arthritis in first degree relatives of patients with the disease. Environmental factors have been implicated. Streptococcal infection may precipitate the development of guttate psoriasis. HIV infection may present with psoriasis and psoriatic arthritis, as well as worsen existing disease.

Gout is one of the most painful forms of arthritis. Incorrectly when the drop is believed that a disease of the rich and famous due to the consumption of too much rich food and fine wines. Gout is a disease due to a congenital disorder of the metabolism of uric acid. Uric acid is produced when purines are broken down by enzymes in the liver. Purines can be generated by the body itself (via the breakdown of normal cell turnover in the cell) or can be ingested in purine-rich foods (eg seafood, beer). Gout usually attacks the big toe (approximately 75% of first attacks), but can also affect other joints like the ankle, heel, instep, knee, wrist, elbow, fingers and spine. In some cases the condition can occur in the joints of small toes that have become immobile due to impact injury earlier in life, causing poor blood circulation that leads to gout. Chronic gout can lead to deposits of hard lumps of uric acid in and around the joints, decreased kidney function and kidney stones. An acute attack of gout is an inflammatory arthritis, often with intense swelling, redness and warmth around the joint. The inflammatory component is so intense, an acute attack of gout is often confused with bacterial cellulitis. Gout is mainly treated with anti-inflammatory drugs. Corticosteroids (also called steroids) may be prescribed for people who can not take NSAIDs. Steroids also work by decreasing inflammation. Steroids can be injected into the affected joint or given as pills. Colchicine is often used to treat gout and usually starts working within a few hours of taking it.

Septic arthritis is also known pyogenic arthritis. Septic arthritis is infection, usually bacterial, across the cavity. Septic arthritis usually affects only one joint, though occasionally it may occur in more than one joint at a time. It is the most dangerous form of acute arthritis. The joint cavity is usually a sterile space, with synovial fluid and cellular matter including some white blood cells. Many different types of bacteria (germs) can cause septic arthritis. Infection with a bacterium called Staph. aureus is the most common. Septic arthritis is an inflammation of a synovial membrane with purulent effusion in the joint capsule, usually due to bacterial infection. This disease entity also is referred to in literature as bacterial, suppurative, purulent, or infectious arthritis. The most common bacterial isolates in native joints include gram-positive cocci, with S. aureus was found in 40% to 50% of cases. Septic arthritis is uncommon from adolescence to the age of 3 years. Children with arthritis are more likely than adults to be infected with group B streptococcus and Haemophilus influenza. Young children and older adults are more likely to develop arthritis. As the population ages, doctors are finding that septic arthritis is increasingly common. The symptoms of septic arthritis occur suddenly and are characterized by pain, swelling in the affected joint, along with acute pain. Chills and fever are also common symptoms. Chronic septic arthritis (which occurs less frequently) is caused by organisms such as Mycobacterium tuberculosis and Candida albicans. Knee and hip joints are most commonly infected