What is Inflammatory Arthritis?
Inflammatory arthritis is an umbrella term used for conditions that cause inflammation in the joint. This can include rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, lupus-associated arthritis, and crystal arthropathy including gout and pseudogout.
Possible Causes:
All types of inflammatory arthritis share a similar pathology, that is, an overactive immune system or autoimmunity. Inflammatory arthritis is a chronic autoimmune process whereby immune cells attack our own cells, causing inflammation in the tissues around the joint. Gouty arthritis is unique because it is precipitated by an increased production of uric acid by the body instead of an autoimmune process.
Risk Factors
Each type of inflammatory arthritis has different risk factors associated with it. Generally speaking, increasing age, genetics, smoking, and obesity can increase the risk of all types of inflammatory arthritis. Women are more likely to get inflammatory arthritis such as rheumatoid arthritis and lupus, whereas men are at a higher risk of being diagnosed with ankylosing spondylitis and gouty arthritis.
Signs and Symptoms
The most common signs and symptoms associated with most inflammatory arthritis include:
- Redness and warmth around the joint involved
- Tenderness around the joint involved
- Joint pain and stiffness that is typically worse in the early morning (morning stiffness)
- Swelling around the joint involved
- Similar inflammatory signs in other organs of the body such as the heart
- Waxing and waning or ‘flares’ of symptoms
- Deformity of the joints in severe, untreated cases
Diagnosis
Each type of inflammatory arthritis is diagnosed differently. Blood tests that include ESR and CRP levels are typically elevated in all types, whereas certain markers such as anti-CCP and rheumatoid factor are increased in rheumatoid arthritis and lupus. An X-ray or MRI scan can be useful in making a preliminary diagnosis of arthritis. Soft tissue swelling, bony erosions, and extra bone growth can all sometimes be seen in a patient with rheumatoid arthritis and other forms or inflammatory arthritis.
Treatment Options
Currently, no cure exists for inflammatory arthritis. However, medicines that decrease the activity of immune cells have been successful in treating the symptoms of inflammatory arthritis. Typically, when the arthritis is in its early stages, non-steroidal inflammatory drugs (NSAIDs) are used as first line to curb the inflammation. These are sometimes used in combination with steroidal medications such as prednisone for a stronger effect. When symptoms or flares of inflammatory arthritis such as rheumatoid arthritis are not controlled with NSAIDs or steroids, disease-modifying anti-rheumatic drugs (DMARDs) are added. These include methotrexate, leflunomide, sulfasalazine and hydroxychloroquine. Sometimes, biological agents such as anakinra, adalimumab, certolizumab are also used in severe cases. Patients with gouty arthritis, on the other hand, require treatment with a xanthine oxidase inhibitor such as allopurinol instead to bring down uric acid levels.
FAQs
Q. Are there surgical options available for treating inflammatory arthritis?
Surgery is typically kept as a last resort when medication fail to improve symptoms or when there is severe joint damage. Surgical options include a tendon repair, synovectomy, joint fusion, and sometimes a total joint replacement.
Q. What are some lifestyle/home remedies for inflammatory arthritis?
Gentle regular exercise can help strengthen muscles around the joint and relieve pain. However, if the joint is extremely painful or severely damaged, exercising it is not advised. Heat and cold application may also bring some relief to painful joints.