Infectious Arthritis

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Infectious arthritis is joint inflammation due to an infection in a joint. It is almost always curable. When diagnosed and treated promptly, there is usually no lasting joint damage. If not treated early, then joint damage may occur.

Infectious arthritis can be caused by:

* bacterial illnesses such as gonorrhea, staph infections, and Lyme Disease or

* viral infections such as hepatitis, mumps, German measles, and mononucleosis

Bacterial infections are treated with drugs. A viral infection will usually go away on its own.

Infectious arthritis most often affects only one joint, although two or three joints may be involved. The shoulders, hips, and knees are most often affected. Red tender bumps about the size of a quarter may occur on the skin of the lower legs. Other symptoms include fever, and ankle or other joint swelling and pain.

People who are at higher risk for this disease include those who have:

* diabetes

* sickle cell anemia

* severe kidney disease

* HIV or AIDS

* some kinds of cancer

* an abnormal heart valve or

* an IV drug use problem

Certain drugs can decrease a person’s ability to resist infections. For example, people who receive repeated steroid shots into the same joint risk getting an infection in that joint.

Certain jobs can expose workers to infectious arthritis. People more likely to get it include those who work with animals, plants or soil. These include farmers, gardeners, and fishermen. Infectious arthritis is not contagious. For more information, call the Arthritis Foundation at (800) 283-7800.

OSTEOARTHRITIS

Osteoarthritis is the most common type of a degenerative joint disease or arthritis. It usually begins in people over the age of 60.

Osteoarthritis progresses slowly. It begins with joint pain and stiffness. Later the joint enlarges and movement becomes limited. The cartilage breaks down first. Cartilage is the joint’s cushion that covers the ends of bones allowing free movement. It becomes rough, frays, or wears away, leaving bones to grind against each other. As a result, the joint becomes irritated and inflamed. Sometimes the irritation causes abnormal bone growths known as spurs that increase swelling. The disease normally affects the feet, knees, hips, and fingers. Only one to a few joints are affected at one time.

Excessive or unusual wear of the joints can start the disease. This includes being overweight, poor posture, injury, repetitive strain from work, sports, or recreation, or a combination of these.

The most common symptoms of osteoarthritis are pain and stiffness. Using the affected joint causes pain. This is especially true with finger joints and those that bear the body’s weight. Enlargement of the fingers at the last joint may result, but seldom leads to disability. Pain and swelling increase with joint usage. These symptoms may be relieved somewhat with rest.

The development of osteoarthritis speeds up when an injury or overuse affects a weight-bearing joint. In young people, injuries and overuse can activate the disease. The weight-bearing joints of the knees, hips and spine are the most likely joints to be afflicted. However, wrists, elbows, and shoulders may be affected as well. Over the course of a normal lifetime, cartilage wears down considerably.

Treatment focuses on relieving pain and improving joint function. A wide range of drugs and procedures are available. Losing weight and protecting joints from overuse are important. Canes and splints offer protection. Physical therapy provides relief from pain and muscle spasms, and maintains joint range of motion. Surgery is occasionally used to repair or replace the affected joint.

RHEUMATOID ARTHRITIS

Rheumatoid Arthritis is a disease that affects not only joints, but may also affect the heart, lungs, and eyes. This disease is very painful. Flare-ups are frequent and long lasting. The initial area of attack is the membrane that lines the joint. Cartilage is the joint’s cushion that covers the ends of bones allowing free movement. Over time, arthritis breaks down cartilage as well as the ligaments, muscles, and bones.

Rheumatoid arthritis causes generalized stiffness and aching. It tends to affect more than one joint. Smaller joints such as the wrists, hands, feet, or ankles are the most common sites for this condition. The hips, knees, or elbows may also suffer. Many joints can be affected at the same time. It is common to have the disease in both feet or both hands at the same time.

Primary symptoms include swelling and pain in the smaller joints of the hands and feet. Generalized aching or stiffness occurs, especially after sleeping or lack of use. The affected joints are swollen, painful, and warm to touch during flare-ups. Another symptom is a series of small lumps that range in size from a pea to a walnut. These may develop under the skin near the elbow, the ears or nose, the back of the scalp, over the knee, or under the toes. The lumps are usually not painful or harmful.

Rheumatoid arthritis is often a chronic problem that can result in progressive joint destruction, deformity, and disability. The disease can occur at any age. It is more likely to develop between ages 20 and 50 years. Women are affected three times more often than men.

Treatment focuses on relieving pain and improving joint function. A wide range of drugs and procedures are available. This includes a balance of rest and exercise. Exercise is regular, gentle, and progressive. It may include physical therapy and swimming. Surgery can be used to prevent or repair damage.

JUVENILE RHEUMATOID ARTHRITIS

Arthritis affects 1 out of 1000 children a year. One child in 10 thousand children will have a severe form of the disease. Arthritis in children is similar to arthritis in adults. It can start anytime after birth. Arthritis may affect one or many joints and any size joint.

Onset and severity of symptoms varies between types. Over 30 percent of children develop permanent joint changes. In addition, the growing child may experience abnormal bone growth. For example, the disease may increase growth in one leg bone but not in the other, producing one leg that is longer than the other. Another risk is when a child keeps a joint from moving to avoid pain. Lack of movement can weaken and shorten muscles causing a deformity over time.

Treatment includes:

* drugs to reduce swelling and pain

* range of motion exercises and

* splints to prevent loss of motion and deformity

A balance between normal activity and rest is necessary. This will avoid fatigue and excessive stress on affected joints. To maintain a healthy attitude, do not isolate a child from his or her normal routine. The outlook for juvenile arthritis is often better than that for an adult with arthritis. Many children recover completely.