Arthritis

Diagnosis

The diagnosis of arthritis often starts with a physical examination by a healthcare provider. The doctor usually inquire about the symptoms and how joint discomfort impacts their daily life. A physical exam will be performed to evaluate joint mobility and range of motion, examine the joints for areas of swelling, redness or warmth, and assess the patient’s general health to see whether another condition is affecting the symptoms.

• Laboratory tests: Blood, urine, and joint fluid are body fluids that are frequently subjected to testing. The study of several types of body fluids can assist in determining the sort of arthritis patients may have. To get a sample of joint fluid, the affected area is often washed and numbed before a needle is inserted into the joint space to extract the needed fluid for analysis.
• Imaging: Imaging exams can provide a clear picture of the bones, joints, and soft tissues. These tests might discover issues within the joint that are causing the discomfort. The doctor may require any of the following imaging tests:
  • X-rays. X-rays are frequently used to monitor disease progression. However, they may not detect early arthritic damage. X-rays, which use low doses of radiation to examine bone, can reveal cartilage loss, bone deterioration, and bone spurs.
  • Computerized tomography (CT). CT scans can show the bone and the soft tissues that cover it. It collects X-rays from various angles and combine the data to create cross-sectional pictures of inside structures.
  • Magnetic resonance imaging (MRI). MRIs can provide more accurate cross-sectional imaging of soft tissues which can reveal of there is any injuries to the muscles, ligaments, or tendons near the joints. MRI uses radio waves with a strong magnetic field in generating detailed images.
  • Ultrasound. This may be used to assist needle placement when extracting joint fluid or injecting drugs into the joint. Ultrasound employs high-frequency sound waves to imaging soft tissues, cartilage, and fluid-containing structures near joints.

Treatment

While arthritis does not have a definitive cure, there are various treatments available that can help manage the symptoms and improve joint function. The approach to treatment will depend on the severity of the arthritis, its symptoms, and the patient’s overall health. Treatment may involve a combination of nonsurgical and surgical approaches.

• Medications: Among the most commonly used arthritis drugs are:
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs, often available in tablet, cream, or gel form, can reduce swelling and ease discomfort cause by arthritis. Stronger dose of NSAIDs which are only accessible through prescription can cause stomach upset and raise the chances of having a heart attack or stroke.
  • Counterirritants: Applying certain solutions on the aching joint’s skin may interfere with the passage of pain signals from the joint, which is usually found on certain lotions and ointments that contain menthol or capsaicin, the chemical that gives hot peppers their spiciness.
  • Steroids: Cortisone may provide temporary relief from joint pain and inflammation. Corticosteroids can be either orally or injected into the aching joint. Adverse effects may include bone weakening, weight gain, and diabetes.
  • Disease-modifying antirheumatic drugs (DMARDs): Aside from conventional DMARDs, biologic medicines and targeted synthetic DMARDs are also available to manage arthritis. Biologics are drugs that target the immune system’s inflammatory reaction. Biologics may be recommended for patients with rheumatoid or psoriatic arthritis. DMARDs can reduce the progression of rheumatoid arthritis and prevent irreparable damage to joints and other tissues. However, it may increase the risk of infection as a side effect.
• Therapy: Rehabilitation can assist in increasing strength, range of motion, and overall mobility. Occupational therapists can educate patients on how to modify their normal tasks to reduce arthritis discomfort. Splints or braces may be necessary in some circumstances. Generally, certain kinds of arthritis may benefit from physical therapy.
• Surgery: Surgical intervention is normally recommended only in severe cases of arthritis. Or in cases where medication or nonsurgical approaches failed to improve the condition. Surgical alternatives include:
  • Joint repair: This is frequently performed arthroscopically or by making small incisions over the joint. Through this procedure, joint surfaces can be polished or realigned to alleviate pain and increase function.
  • Joint replacement: This is the replacement of a damaged, arthritic joint with an artificial joint. Joint replacement keeps joint function and movement intact. Ankle replacement, hip replacement, knee replacement, and shoulder replacement are a few examples.
  • Joint fusion: Fusion is the permanent joining of two or more bones. It separates the ends of the two bones of the joint and then locks them together until they heal into a single stiff unit. Fusion immobilizes a joint and alleviates movement-related discomfort. This surgery is more commonly utilized for smaller joints including the wrist, ankle, and fingers.