Arthritis: Rheumatoid Arthritis and Osteoarthritis

Arthritis occurs when the cartilage, the connective tissue that protects the joints, wears out. There are different causes of breaking down of cartilage. In osteoarthritis, the cartilage breaks down due to the overuse of the affected joint(s). Although usually a disease of ageing, this degenerative disease can also happen to young people as a result of past sports injuries. On the other hand, rheumatoid arthritis occurs when the immune system attacks the body instead of protecting it, causing the swelling of the joints.

Risk factors of arthritis

There are some factors that increase the possibility of acquiring arthritis. While some are beyond your control, you can do something about the risk factors that you can still change to lessen your probability of suffering from arthritis. These factors include:

• Age
• Gender
• Genetics or family history
• Being overweight or obese
• Lack of physical activities
• Smoking
• Past injuries
• Infection
• Poor posture
• Occupations that require repetitive physical movements like kneeling, lifting, climbing stairs etc.

Osteoarthritis worsens as the day progresses. By evening, the person is likely to feel a dull ache in the affected joint.

Other symptoms of arthritis include:

• A sensation of grating or grinding in the affected joint caused by rubbing of the damaged cartilage surface (called crepitation)
• Changes in surrounding joints
• Cysts (lumps) in the hand that may cause ridging or dents in the nail plate of the affected finger
• Pain
• Stiffness of the affected joints
• Swelling in the affected joints
• Warmth – The joint may feel warm to the touch

If you feel any symptoms of arthritis, visit your doctor for a physical exam. The doctor will ask about your symptoms and check your joints for any swelling, redness or pain. To further evaluate your condition, the doctor may need some of the following diagnostic tests and procedures:

• Laboratory tests – Lab test results are important in determining the form of arthritis or ruling out other health conditions that may be causing your symptoms. Some tests that your doctor may request are blood test, urinalysis and join fluid analysis.
• X-ray – X-ray images can help detect changes and damage in the bone, cartilage and joints. It is a useful test in monitoring disease progression.
• Ultrasound – In an ultrasound test, the technician will apply a gel on your affected body part and rub a small transducer or probe on your skin. Through high-frequency sound waves, an ultrasound can get an image of the cartilage, soft tissues and other structures near your joints.
• Computerised Tomography (CT) scan – CT scan results can help examine joints that hard to evaluate using the conventional X-ray. Using special x-ray equipment and computer, CT scans can look into areas that are difficult to reach like the spine or pelvis.
• Magnetic Resonance Imaging (MRI) – MRI provides 3D images of tissues, bones and joints. It shows infections, tears and swelling. It can also detect early signs of arthritis that can't be seen on X-ray.

To relieve arthritis pain, your doctor will recommend several treatments. Depending on the type of arthritis you have, you will need to undergo a combination of treatments which may include:

• Exercise – To maintain the strength of the muscles and ligaments to stabilise the joints
• Medicines – Disease-modifying anti-rheumatic drugs for rheumatoid arthritis
• Non-steroidal anti-inflammatory drugs to reduce pain, swelling and stiffness
• Steroids may be injected directly into a joint to ease pain and swelling
• Physiotherapy – Exercises to stabilise the joint
• Surgery – To correct joint deformity or to replace a badly damaged joint

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Rheumatoid arthritis can affect many organs in the body. Therefore, treatment is important to prevent anaemia (low levels of red blood cells or haemoglobin in the blood), fibrosis (thickening and scarring) of the lung(s), risk of heart attacks and strokes, and some cancers.