What Type of Arthritis Do You Have?
100 Types of Joint Pain
Arthritis is not just a disease of the elderly. According to the Arthritis Foundation, arthritis affects 50 million Americans—two thirds of whom are under 65.
Over 100 different kinds of arthritis cause joint pain that can be debilitating. Each type has a variety of causes and effective treatments. In order to find the best treatment and management strategy for your arthritis, it’s important to diagnose what type of arthritis you have.
The Arthritis Foundation estimates that 27 million people in the United States suffer from osteoarthritis (OA), making it the most common form of arthritis. Cartilage in the joints breaks down, causing bones to rub together and joints to swell. Age, obesity, injury, family history, and joint overuse are all risk factors.
Joint soreness, stiffness (especially in the morning), and lack of coordination are symptoms of OA.
To determine if you have OA, your doctor will ask for a medical history and physical exam. X-rays and other visualization tests will be performed. The joint may be aspirated, which means fluid is taken from inside the joint to rule out infection.
Autoimmune Arthritis: Rheumatoid Arthritis
In autoimmune disease, the body attacks healthy joint tissue and causes pain, swelling and inflammation. The Arthritis Foundation estimates that 1.3 million adults in the United States have rheumatoid arthritis (RA), a form of arthritis caused by autoimmune disease. Seventy percent of people with RA are female.
Symptoms include morning stiffness and joint pain in the same joint on both sides of the body. Eventually joint deformities occur.
Additional symptoms unrelated to the joints (ex. chest pain when taking a breath) may occur with RA and some other forms of autoimmune arthritis. Sjogren’s syndrome frequently occurs with RA, resulting in severe dry eyes and mouth or even eye burning and discharge. Other complications include sleep difficulties, nodules under the skin, and numbness, burning, and tingling in hands and feet.
Autoimmune Arthritis: Testing
No test can absolutely determine if you have RA. However, in addition to the testing done for OA, tests ordered can include:
- rheumatoid factor test
- anti-CCP antibody test
- complete blood count (CBC)
- C-reactive protein (CRP)
- erythrocyte sedimentation rate (ESR)
- genetic tests for rare arthritis forms—i.e. HLA-B27 antigen
These tests can help show if you have an autoimmune reaction and systemic inflammation.
Autoimmune Arthritis: Juvenile Arthritis
Juvenile arthritis (JA) affects children under 16 years old. There are about 300,000 children in the United States with JA. JA is an umbrella term—there are several types of arthritis in children.
The most common is juvenile idiopathic arthritis (a group of autoimmune forms of arthritis that impact joints). This may include muscle and soft tissue tightening, bone erosion, growth pattern changes, and joint misalignment.
Other less common conditions include juvenile dermatomyositis, juvenile lupus, juvenile scleroderma, Still’s disease, and Kawasaki disease.
Months of aching joints, swelling, stiffness, fatigue and fevers can indicate a form of juvenile arthritis.
Autoimmune Arthritis: Spondylarthropathies
Ankylosing spondylitis (AS) and other spondylarthropathies are autoimmune conditions that attack the sites where tendons and ligaments attach to bone. Symptoms include pain and stiffness, especially in the lower back. The spine is usually affected the most, though some forms attack hands and feet. Eventually, bone destruction can occur, causing deformation of the spine and dysfunction of the shoulders and hips.
This group of arthritis is hereditary. Most people who suffer from one of these forms of arthritis have the HLA-B27 gene. Caucasians are most likely to be afflicted. AS starts in the teens and twenties, and is three times more likely in males than females.
Other diseases with the HLA-B27 association include Reiter’s syndrome, psoriatic arthritis, enteropathic arthropathy, and some forms of juvenile arthritis.
Autoimmune Arthritis: Lupus Erythematosus
Systemic lupus erythematosus (SLE) is another autoimmune disease that can affect joints. Many types of connective tissue are attacked in patients with SLE. SLE can damage joints, skin, kidneys, the brain, and other organs as well. Lupus is more common in women, and more likely in those with African or Asian ancestry.
Joint pain and swelling are common symptoms. Other symptoms include chest pain, fatigue, fever, uneasiness, hair loss, mouth sores, a skin rash on the face, sensitivity to sunlight, and swollen lymph nodes. More severe effects are possible with disease progression.
Gout is a form of arthritis caused by the accumulation of urate crystals inside joints. High levels of uric acid in your blood can put you at risk for gout. According to the Centers for Disease Control and Prevention (CDC), an estimated 64 people in 1000 have gout, and the ratio of men to women is more than 3 to 1. Age, diet, alcohol use, and family history may put you at risk.
Gout can be incredibly painful. The joint most often affected is in the big toe. Redness, swelling, and intense pain can occur in the feet, ankles, knees, hands, or wrists. An acute attack lasts 12 to 24 hours, with weeks of lingering pain. Gout becomes more severe over time, affecting multiple joints.
An infection inside a joint can cause pain and swelling. Bacteria, viruses, or fungi can infect a joint by spreading from another part of the body. This kind of arthritis is often accompanied by a fever and chills. This can also be called septic arthritis.
Reactive arthritis can occur when an infection happens in another part of the body. The infection often starts in the bladder or sexual organs, but it can cause inflammation in a joint somewhere else in the body. This is also referred to as Reiter’s syndrome.
Blood and urine tests and sampling the fluid inside the joint can determine if your joint pain is caused by an infection.
There are many, many other forms of arthritis or conditions that can lead to pain in the joints. A few more examples include:
- fibromyalgia: the brain processes pain in muscles and joints differently, magnifying pain
- psoriatic arthritis: pain in toes or fingers that occurs in people with chronic psoriasis
- scleroderma: stiffening in the skin and damage to small blood vessels can lead to joint pain
Talk to your doctor about your symptoms. He or she can help determine what’s causing your joint pain and how best to treat it.
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