ARTHRITIS

The word `arthritis', literally means, “Inflammation of the joint." The term is used to describe a group of distinct diseases, primarily affecting joints of the body, all having related symptoms. These may include pain, swelling, and stiffness of the joints and surrounding areas. Arthritis can attack one or many joints, suddenly or more gradually over time, depending on the particular type one may have. Similarly the symptoms may be constant or may come and go (called as exacerbations and remissions), but generally the effects of arthritis are chronic, meaning that they will last for a long time, even life long.

Anatomy and Pathology: what is normal and what happens in arthritis?

The surfaces of the bones in the joint are normally covered with a thin layer called articular cartilage. This cartilage is smooth and slippery. When the joint bends or twists, the cartilage keeps the movement smooth and fluid. Finally, the joint itself is surrounded by the synovium, which is a thin layer of tissue that produces synovial fluid. This layer, plus thicker ligamentous tissue, forms a "capsule" around the joint, with the fluid inside keeping the joint well-lubricated. Each of our joints is built differently—some joints work as a hinge, others swivel, and some do a combination of several different types of motion. But all share a set of common characteristics. In most joints, two bones meet, end-to-end. They are connected to each other directly by ligaments, which are short fibrous strips of tissue placed at several different points in the joint, at different angles, holding the bones in the correct position during motion. Stability is also provided by the muscles surrounding the joint, which attach to the bone by tendons.

Arthritis is a condition that attacks the joints and tissues surrounding them, as well as other parts of the body in some types. The main pathology causing symptom in arthritis is the erosion of articular cartilages. As mentioned above, the function of these cartilages is to ensure smooth pain free movements of the joint and absorb stress. When these get eroded, bones come in direct contact with each other causing friction and painful movements. Other surrounding tissue may be directly or indirectly depending on the type of arthritis. The synovium, which is the layer producing the fluid for lubrication may get hypertrophied and produce more fluid causing swelling of the joint, the muscles surrounding the joint may get thinned (atrophied), The alignment of the limb may change due to asymmetrical wearing of the articular cartilage and ligaments may get loose (laxity).

What are the types of arthritis?

There are more than 100 different types of arthritis, some are more common than others. The four types that are the most prevalent in both the adult and children include:

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Osteoarthritis

Rheumatoid Arthritis

Gout and Pseudogout

Ankylosing Spondylitis

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