There are probably many genes that make people more likely to have arthritis. Research has found some of these genes. If you have the gene linked with arthritis, something in your environment—such as a virus or injury—may trigger the condition.
Different Types of Arthritis
There are probably many genes that make people more likely to have arthritis. Research has found some of these genes. If you have the gene linked with arthritis, something in your environment—such as a virus or injury—may trigger the condition.
Points To Remember About Arthritis
"Arthritis" means joint inflammation. Although joint inflammation is a symptom or sign rather than a specific diagnosis, the term arthritis is often used to refer to any disorder that affects the joints.
There are many types of arthritis, including ankylosing spondylitis, gout, juvenile arthritis, osteoarthritis, psoriatic arthritis, reactive arthritis, and rheumatoid arthritis.
Medications and surgery can treat arthritis.
Activities that can help reduce symptoms at home include exercise; hot and cold therapies; relaxation therapies; splints and braces; and assistive devices.
Overview of Arthritis
"Arthritis" literally means joint inflammation. Although joint inflammation is a symptom or sign rather than a specific diagnosis, the term arthritis is often used to refer to any disorder that affects the joints. Joints are places where two bones meet, such as your elbow or knee.
There are different types of arthritis. In some diseases in which arthritis occurs, other organs, such as your eyes, heart, or skin, can also be affected.
Fortunately, current treatments allow most people with arthritis to lead active and productive lives.
What causes arthritis?
There are probably many genes that make people more likely to have arthritis. Research has found some of these genes.
If you have the gene linked with arthritis, something in your environment—such as a virus or injury—may trigger the condition.
What are the types of arthritis?
There are several types of arthritis. Common ones include:
Ankylosing Spondylitis is arthritis that affects the spine. It often involves redness, heat, swelling, and pain in the spine or in the joint where the bottom of the spine joins the pelvic bone.
Gout is caused by crystals that build up in the joints. It usually affects the big toe, but many other joints may be affected.
Juvenile Arthritis is the term used to describe arthritis in children. Arthritis is caused by inflammation of the joints.
Osteoarthritis usually comes with age and most often affects the fingers, knees, and hips. Sometimes osteoarthritis follows a joint injury. For example, you might have badly injured your knee when young and develop arthritis in your knee joint years later.
Psoriatic Arthritis can occur in people who have psoriasis (scaly red and white skin patches). It affects the skin, joints, and areas where tissues attach to bone.
Reactive Arthritis is pain or swelling in a joint that is caused by an infection in your body. You may also have red, swollen eyes and a swollen urinary tract.
Rheumatoid arthritis happens when the body’s own defense system doesn’t work properly. It affects joints and bones (often of the hands and feet), and may also affect internal organs and systems. You may feel sick or tired, and you may have a fever.
Arthritis is seen with other conditions. These include:
What are the symptoms of arthritis?
Symptoms of arthritis can include:
Pain, redness, heat, and swelling in your joints.
Trouble moving around.
Fever.
Weight loss.
Breathing problems.
Rash or itch.
These symptoms may also be signs of other illnesses.
What causes arthritis?
Some genes have been identified in certain types of arthritis, such as rheumatoid arthritis and juvenile arthritis. People with osteoarthritis may have inherited cartilage weakness.
If you have the gene, something in your environment may trigger the condition. For example, repeated joint injury may lead to osteoarthritis.
Is there a test for arthritis?
To diagnosis you with arthritis or another rheumatic disease, your doctor may:
Ask you about your medical history.
Give you a physical exam.
Take samples for a laboratory test.
Take x-rays.
How is arthritis treated?
There are many treatments that can help relieve pain and help you live with arthritis. You should talk to your doctor about the best treatments for you, which can include:
Medications to relieve pain, slow the condition, and prevent further damage.
Surgery to repair joint damage or relieve pain.
Living with arthritis
There are many things you can do to help you live with arthritis and other rheumatic diseases, including:
Take your medications when and how you’re supposed to.
Exercise to reduce joint pain and stiffness. It also helps with losing weight, which reduces stress on the joints. You should speak to your doctor about a safe, well-rounded exercise program.
Use heat and cold therapies to reduce joint pain and swelling.
Try relaxation therapy to help reduce pain by learning ways to relax your muscles.
Use splints and braces to support weakened joints or allow them to rest. You should see your doctor to make sure your splint or brace fits well.
Use assistive devices, such as a cane or shoe insert, to ease pain when walking. Other devices can help you open a jar, close zippers, or hold pencils.
Ankylosing spondylitis
What is ankylosing spondylitis?
Points To Remember About Ankylosing Spondylitis
Ankylosing spondylitis (AS) is arthritis that affects the spine.
AS often involves redness, heat, swelling, and pain in the spine or where the bottom of the spine joins the pelvic bone.
AS may also affect the shoulders, ribs, hips, knees, feet, eyes, and bowel.
Treatments for AS typically include medicines, exercise, and proper diet. Surgery may be recommended in some cases.
See your doctor often and follow the treatment plan your doctor gave you.
Side and back views of the spine
Ankylosing spondylitis (AS) is a type of arthritis that affects the spine. AS often involves redness, heat, swelling, and pain in the spine or in the joint where the bottom of the spine (sacrum) joins the pelvic bone (ilium).
In some people, AS can also affect the shoulders, ribs, hips, knees, and feet. It can also affect areas where the tendons and ligaments attach to the bones. Sometimes it can affect the eyes, bowel, and very rarely, the heart and lungs.
Many people with AS have mild back pain that comes and goes. Others have severe pain that doesn’t go away. Sometimes the spine becomes stiff. In the worst cases, the swelling can cause two or more bones of the spine to fuse. This may stiffen the rib cage, making it hard to take a deep breath.
Who gets ankylosing spondylitis?
A combination of genes may make it more likely you will get ankylosing spondylitis (AS). The environment also probably plays a role. Men are about twice more likely than women to get AS.
What causes ankylosing spondylitis?
The cause of ankylosing spondylitis (AS) is unknown. It’s likely that genes (passed from parents to children) and the environment both play a role. The main gene associated with the risk for AS is called HLA-B27. Having the gene doesn’t mean you will get AS. Fewer than 1 of 20 people with HLA-B27 gets AS. Scientists recently discovered two more genes (IL23R and ERAP1) that, along with HLA-B27, make it more likely you will get AS.
Is there a test for ankylosing spondylitis?
To test for ankylosing spondylitis, your doctor will need:
A medical history.
A physical exam.
Images of your bones and joints.
Blood tests.
How is ankylosing spondylitis treated?
There is no cure for ankylosing spondylitis (AS). Some treatments help symptoms and may keep the disease from getting worse. In most cases, your treatment will include medicine, exercise, and a healthy diet. In some cases, surgery can repair some joint damage.
Medicines: Several types of medicines are used to treat AS. It is important to work with your doctor to find the safest and most effective medicine for you. Medicines for AS include:
Nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs relieve pain and swelling. Aspirin, ibuprofen, and naproxen are examples of NSAIDs.
Corticosteroids. These strong drugs are similar to the cortisone made by your body. They fight pain and swelling.
Disease-modifying antirheumatic drugs (DMARDs). These drugs work in different ways to reduce pain and swelling in AS.
Biologic agents. These are newer types of medicine. They block proteins involved with pain and swelling.
Exercise: Exercise and stretching may help painful, stiff joints. It should be done carefully and increased gradually. Before beginning an exercise program, it’s important to speak with a doctor to decide on an exercise program. Many people with AS find it helpful to exercise in water. Two types of exercises may help:
Exercises to make you stronger.
Exercises where you gently straighten and bend your joints as far as they will comfortably go.
Diet: A healthy diet is good for everyone and may be very helpful if you have AS. Keeping a healthy weight reduces stress on painful joints. Omega-3 fatty acids, found in coldwater fish (such as tuna and salmon), flax seeds, and walnuts, might help. This is still being studied.
Surgery: If AS causes joint damage that makes daily activities difficult, joint replacement may be an option. The knee and hip are the joints most often replaced. In very rare cases, your doctor may suggest surgery to straighten the spin. This can only be done by a surgeon with a lot of experience in the procedure.
Who treats ankylosing spondylitis?
A rheumatologist usually diagnosis you with ankylosing spondylitis (AS). This is a doctor trained to treat arthritis and related conditions. Because AS can affect different parts of your body, you may need to see more than one doctor. Some other doctors who treat AS symptoms are:
An ophthalmologist, who treats eye disease.
A gastroenterologist, who treats bowel disease.
A physiatrist, who specializes in physical medicine and rehabilitation.
A physical therapist, who provides stretching and exercise programs.
Living with ankylosing spondylitis
These are important things you can do:
See your doctor often.
Follow the treatment plan that your doctor gave you.
Stay active with regular exercise.
Maintain a healthy diet.
Practice good posture.
Don’t smoke.
Arthritis: About Gout
Points To Remember About Gout
Gout is a common condition that causes attacks of pain and swelling in your joints, especially your big toe.
Gout is caused by uric acid crystals building up in your joints and kidneys.
You can reduce your risk of gout attacks by limiting alcohol and foods high in a substance called purines.
Your doctor can recommend medicines and treatments to reduce the pain of gout attacks and help you have fewer attacks.
Proper treatment of gout can prevent permanent damage to your joints and kidneys.
Overview of Gout
Gout is a kind of arthritis that causes attacks of pain and stiffness in your joints, especially your big toe. Gout is caused by crystals of a substance called uric acid building up in your joints. It can also cause lumps under the skin and kidney stones.
For some people, gout progresses through several stages:
Hyperuricemia, when you have elevated levels of uric acid in your blood, but no symptoms.
Acute gout, when you have an attack of intense pain and swelling in your joints. Acute attacks often come on at night and can be triggered by stress, drugs, alcohol, or another illness. An acute attack usually clears up within three to 10 days, even without treatment.
Interval or intercritical gout, which is the time between gout attacks when you don’t have any symptoms.
Chronic tophaceous gout, a late stage of gout when the condition may have permanently damaged your joints and kidneys. With proper treatment, most people do not reach this stage.
Who Gets Gout?
Millions of people get gout. It is especially common in men between the ages of 40 and 50. Women rarely develop gout before menopause.
You are more likely to get it if you:
Have a family history of gout.
Have had an organ transplant.
Are a man.
Are an adult.
Are overweight.
Drink alcohol.
Eat foods that are rich in purines, a substance that breaks down into uric acid.
Are exposed to lead in your environment.
Some health problems can also increase your risk of getting gout, including:
Renal insufficiency, a condition in which your kidneys don’t eliminate enough waste.
High blood pressure.
Hypothyroidism, a condition in which your thyroid gland is underactive.
A condition that cause your cells to turnover rapidly, such as psoriasis, hemolytic anemia, or some cancers.
Kelley-Seegmiller syndrome or Lesch-Nyhan syndrome, two rare conditions in which your body either doesn’t have the enzyme that regulates uric acid levels or doesn’t have enough of that enzyme.
Some medications can increase your risk of getting gout, including:
Diuretics, which help your body eliminate excess fluid.
Salicylate-containing drugs, such as aspirin.
Niacin, a vitamin.
Cyclosporine, a medication used to treat some autoimmune diseases and people who have had organ transplants.
Levodopa, a medication prescribed to treat Parkinson’s disease.
Symptoms of Gout
Gout causes pain in your joints, often in the big toe. Many people get their first attack of gout in one of their big toes, but it can also affect other joints in your feet, arms, and legs. In addition to pain, your joint may feel swollen, red, warm, and stiff.
Gout attacks often start suddenly at night. Intense pain and swelling may be bad enough to wake you up. Gout attacks are often triggered by stressful events, alcohol, drugs, or another illness.
Usually, a gout attack will get better in three to 10 days, even without treatment. After that, you may not have another attack for months or even years. Over time, however, your attacks may last longer and happen more often.
Causes of Gout
Gout is caused when a substance in your body called uric acid forms crystals in your joints. This causes pain, swelling, and other symptoms.
Uric acid comes from purines, which are found in your body’s tissues and many foods. When purines break down, they become uric acid. Uric acid normally dissolves in your blood and passes out of your body in urine. When too much of it builds up in your blood, however, it can form the crystals in your joints that cause gout.
Things that can cause uric acid to build up in the blood include:
Your body increasing the amount of uric acid it makes.
Your kidneys not getting rid of enough uric acid.
Eating too many foods high in purines, such as liver, dried beans and peas, and anchovies.
Diagnosis of Gout
Gout can be difficult to diagnose because its symptoms are similar to several different conditions. Your doctor may test your blood to see if you have high levels of uric acid. They may also draw a sample of fluid from one of your painful joints to look for crystals of uric acid.
Treatment of Gout
Proper treatment can reduce the pain from gout attacks, help prevent future attacks, and prevent damage to your joints.
Your doctor may recommend medications to treat your pain. These may include:
Anti-inflammatory drugs (NSAIDs), which can reduce pain and swelling.
Corticosteroids, such as prednisone, which are strong anti-inflammatory hormones.
Colchicine, which works best when taken within the first 12 hours of a gout attack.
Other medications to reduce symptoms or reduce the build-up of uric acid in your blood.
Your doctor may also recommend diet and lifestyle changes, such as losing weight, since being overweight puts you at a greater risk of gout attacks, and cutting back on alcohol and foods that are high in purines.
Living With Gout
In addition to taking medications recommended by your doctor, you can make some changes to your diet to help you have fewer gout attacks. As always, talk with your doctor before making any changes to your diet or medications.
Your doctor may recommend that you lose weight, if you are overweight, or drink less alcohol. You can also avoid eating foods with lots of purines, since they can increase your uric acid levels. Foods that are high in purines include:
Anchovies.
Asparagus.
Beef kidneys.
Brains.
Dried beans and peas.
Game meats.
Gravy.
Herring.
Liver.
Mackerel.
Mushrooms.
Sardines.
Scallops.
Sweetbreads.
Prevention of Gout
Your risk of getting gout is determined by a number of factors, including genetics, your age and sex, your environment, and what you eat. Here are some things that may lower your risk of getting gout:
Don’t drink too much alcohol.
Don’t eat many foods that are high in purines.
Lose weight, if you are overweight.
Prognosis of Gout
Gout is one of the most controllable forms of arthritis. Treatment and dietary changes can help many people avoid frequent gout attacks and reduce their severity. You may have an acute attack followed by months or even years without any symptoms.
Proper treatment can also help you avoid a condition called chronic tophaceous gout, which can develop over 10 years or so and cause permanent damage to your joints and kidneys. Talk to your doctor about how best to manage your condition.
Research Progress Related to Gout
NIAMS continues to support research on treatments for gout, including:
Determining which medications and dosages are the most effective.
Researching potential new therapies.
Studying which foods improve or worsen gout symptoms.
Studying which cells are involved in gout attacks.
Researching how genetics and environmental factors can lead to gout.
Juvenile Arthritis
Points To Remember About Juvenile Arthritis
Juvenile arthritis is the term used to describe arthritis, or inflammation of the joints, in children.
The most common symptoms of juvenile arthritis are joint swelling, pain, and stiffness that don’t go away.
Juvenile arthritis is usually an autoimmune disorder. In an autoimmune disorder, the immune system attacks some of the body’s own healthy cells and tissues.
To diagnose juvenile arthritis, a doctor may perform a physical exam, ask about family health history, and order lab or blood tests, and x-rays.
Juvenile arthritis can make it hard to take part in social and after-school activities, and it can make schoolwork more difficult. But, all family members can help the child both physically and emotionally.
Exercise is key to reducing the symptoms of arthritis and maintaining range of motion of the joints.
Inflammation inside of the eye and growth problems may also occur with juvenile arthritis.
What is juvenile arthritis?
Juvenile arthritis is the term used to describe arthritis in children. Children can get arthritis just like adults. Arthritis is caused by inflammation of the joints. A joint is where two or more bones are joined together. Arthritis causes
Pain.
Swelling.
Stiffness.
Loss of motion.
The most common type of arthritis in children is called juvenile idiopathic arthritis (idiopathic means “from unknown causes”). There are several other forms of arthritis affecting children.
Juvenile arthritis is a rheumatic disease, or one that causes loss of function due to an inflamed supporting structure or structures of the body. Some rheumatic diseases also can involve internal organs.
Who gets juvenile arthritis?
Juvenile arthritis affects children of all ages and ethnic backgrounds. About 294,000 American children under age 18 have arthritis or other rheumatic conditions.
What are the symptoms of juvenile arthritis?
The most common symptoms of juvenile arthritis are joint swelling, pain, and stiffness that don’t go away. Usually it affects the knees, hands, and feet, and it’s worse in the morning or after a nap. Other signs can include:
Limping in the morning because of a stiff knee.
Excessive clumsiness.
High fever and skin rash.
Swelling in lymph nodes in the neck and other parts of the body.
Most children with arthritis have times when the symptoms get better or go away (remission) and other times when they get worse (flare).
Types of Juvenile Arthritis
There are seven separate subtypes of juvenile idiopathic arthritis, each with distinct symptoms. However, with every subtype, a child will have arthritis symptoms of joint pain, swelling, tenderness, warmth, or stiffness that last for more than 6 continuous weeks.
The subtypes are:
Systemic juvenile idiopathic arthritis (formerly known as systemic juvenile rheumatoid arthritis). Systemic means the arthritis can affect the whole body, rather than just a specific organ or joint. A child has arthritis with, or that was preceded by, a fever that has lasted for at least 2 weeks. The fever has come and gone, but spiked, or hit its highest temperature, for at least 3 days. The fever occurs with at least one or more of the following:
Generalized enlargement of the lymph nodes.
Enlargement of the liver or spleen.
Inflammation of the lining of the heart (pericarditis) or the lungs (pleuritis).
The characteristic rheumatoid rash, which is flat, pale, pink, and generally not itchy. The individual spots of the rash are usually the size of a quarter or smaller. They are present for a few minutes to a few hours, and then disappear without any changes in the skin. The rash may move from one part of the body to another.
Oligoarticular juvenile idiopathic arthritis (formerly known as pauciarticular juvenile rheumatoid arthritis). A child has arthritis affecting one to four joints during the first 6 months of disease. Two subcategories of this type are:
Persistent oligoarthritis, which means the child never has more than four joints involved throughout the disease course.
Extended oligoarthritis, which means that more than four joints are involved after the first 6 months of the disease.
Polyarticular juvenile idiopathic arthritis – rheumatoid factor negative (formerly known as polyarticular juvenile rheumatoid arthritis – rheumatoid factor negative).A child has arthritis in five or more joints during the first 6 months of disease, and all tests for rheumatoid factor (proteins produced by the immune system that can attack healthy tissue, which are commonly found in rheumatoid arthritis and juvenile arthritis) are negative.
Polyarticular juvenile idiopathic arthritis – rheumatoid factor positive (formerly known as polyarticular rheumatoid arthritis – rheumatoid factor positive). A child has arthritis in five or more joints during the first six months of the disease. Also, at least two tests for rheumatoid factor, at least three months apart, are positive.
Psoriatic juvenile idiopathic arthritis. A child has both arthritis and psoriasis (a skin disease), or has arthritis and at least two of the following:
Inflammation and swelling of an entire finger or toe (this is called dactylitis)
Nail pitting or splitting
A first-degree relative with psoriasis.
Enthesitis-related juvenile idiopathic arthritis. The enthesis is the point at which a ligament, tendon, or joint capsule attaches to the bone. If this point becomes inflamed, it can be tender, swollen, and painful with use. The most common locations are around the knee and at the Achilles tendon on the back of the ankle. A child is diagnosed with this condition if he or she has both arthritis and inflammation of an enthesitis site, or has either arthritis or enthesitis with at least two of the following:
Inflammation of the sacroiliac joints (at the bottom of the back) or pain and stiffness in the lumbosacral area (in the lower back).
A positive blood test for the human leukocyte antigen (HLA) B27 gene.
Onset of arthritis in males after age six years.
A first-degree relative diagnosed with ankylosing spondylitis, enthesitis-related arthritis, or inflammation of the sacroiliac joint in association with inflammatory bowel disease or acute inflammation of the eye.
Undifferentiated arthritis. A child is said to have this condition if the signs and symptoms of the arthritis do not fulfill the criteria for one of the other six categories or if they fulfill the criteria for more than one category.
What are the symptoms of juvenile arthritis?
The most common symptoms of juvenile arthritis are joint swelling, pain, and stiffness that don’t go away. Usually it affects the knees, hands, and feet, and it’s worse in the morning or after a nap. Other signs can include:
Limping in the morning because of a stiff knee.
Excessive clumsiness.
High fever and skin rash.
Swelling in lymph nodes in the neck and other parts of the body.
Most children with arthritis have times when the symptoms get better or go away (remission) and other times when they get worse (flare).
Causes of Juvenile Arthritis
Most forms of juvenile arthritis are autoimmune disorders in which the body’s immune system – which normally helps to fight off bacteria or viruses – mistakenly attacks some of its own healthy cells and tissues. The result is inflammation, marked by redness, heat, pain, and swelling. Inflammation can cause joint damage.
Doctors do not know why the immune system attacks healthy tissues in children who develop juvenile arthritis. Scientists suspect that it is a two-step process. First, something in a child’s genetic makeup gives him or her a tendency to develop juvenile arthritis; then an environmental factor, such as a virus, triggers the development of the disease.
Not all cases of juvenile arthritis are autoimmune, however. Recent research has shown that some people, such as many with systemic arthritis, have what is called an autoinflammatorycondition. Although the two terms sound similar, the disease processes behind autoimmune and autoinflammatory disorders are different.
Autoimmune Disorders
When the immune system is working properly, foreign invaders such as bacteria and viruses provoke the body to produce proteins called antibodies. Antibodies attach to these invaders so the immune system can recognize and destroy them. In an autoimmune reaction, the antibodies attach to the body’s own healthy tissues by mistake, signaling the body to attack them. Because they target the self, these proteins are called autoantibodies.
Autoinflammatory Disorders
Like autoimmune disorders, autoinflammatory conditions also cause inflammation. And like autoimmune disorders, they also involve an overactive immune system. However, autoinflammation is not caused by autoantibodies. Instead, autoinflammation involves a more primitive part of the immune system that, in healthy people, causes white blood cells to destroy harmful substances. When this system goes awry, it causes inflammation for unknown reasons. Besides inflammation, autoinflammatory diseases often cause fever and rashes.
Is there a test for juvenile arthritis?
There is no easy way a doctor can tell if a child has juvenile arthritis. Doctors usually suspect arthritis when a child has symptoms of:
Constant joint pain or swelling.
Skin rashes that can’t be explained.
Fever along with swelling of lymph nodes or inflammation in the body’s organs.
To be sure that it is juvenile arthritis, doctors may:
Perform a physical exam.
Ask about family health history.
Order lab or blood tests.
Order x-rays.
Diagnosis of Juvenile Arthritis
For a doctor to diagnose your child with juvenile arthritis, symptoms must have started before age 16. Doctors usually suspect juvenile arthritis, along with several other possible conditions, when they see children with persistent joint pain or swelling, unexplained skin rashes, and fever associated with swelling of lymph nodes or inflammation of internal organs. A doctor also considers a diagnosis of juvenile arthritis in children with an unexplained limp or excessive clumsiness.
There is no single test that a doctor can use to diagnose juvenile arthritis. A doctor will carefully examine your child and consider his or her medical history and the results of several tests that help confirm juvenile arthritis or rule out other conditions. Specific findings or problems that relate to the joints are the main factors that go into making a juvenile arthritis diagnosis.
Symptoms
When diagnosing juvenile arthritis, a doctor must consider not only the symptoms your child has, but also the length of time these symptoms have been present. Joint swelling or other joint changes that the doctor can see must be present continuously for at least 6 weeks.
You can help your child’s doctor correctly diagnose juvenile arthritis by keeping a record of your child’s symptoms and changes in the joints, noting when they first appeared and when they are worse or better.
Family History
It is very rare for more than one member of a family to have juvenile arthritis. But children with a family member who has juvenile arthritis are at a slightly increased risk of developing it as well.
Research shows that juvenile arthritis is also more likely in families with a history of any autoimmune disease. One study showed that families of children with juvenile arthritis are more likely to have a member with an autoimmune disease such as rheumatoid arthritis, multiple sclerosis, or thyroid inflammation (Hashimoto’s thyroiditis) than are families of children without juvenile arthritis. For that reason, having an autoimmune disease in your family may raise the doctor’s suspicions that your child’s joint symptoms are caused by juvenile arthritis or some other autoimmune disease.
Lab Tests
Lab tests, usually blood tests, cannot alone provide the doctor with a clear diagnosis. But a doctor can use these tests to help rule out other conditions and classify the type of juvenile arthritis that your child has. A doctor may order blood tests for:
Anticyclic citrullinated peptide (anti-CCP) antibodies. Anti-CCP antibodies may be detected in healthy people years before onset of clinical rheumatoid arthritis. They may predict the eventual development of undifferentiated arthritis into rheumatoid arthritis.
Rheumatoid factor (RF). Rheumatoid factor, an autoantibody that is produced in large amounts in adults with rheumatoid arthritis, also may be detected in children with juvenile arthritis, although it is rare. The RF test helps the doctor differentiate among the different types of juvenile arthritis.
Antinuclear antibody (ANA). An autoantibody directed against substances in the cells’ nuclei, ANA is found in some juvenile arthritis patients. However, the presence of ANA in children generally points to some type of connective tissue disease, helping the doctor to narrow down the diagnosis. A positive test in a child with oligoarthritis markedly raises his or her risk of developing eye disease in the future.
Erythrocyte sedimentation rate (ESR or sed rate). This blood test, which measures how fast red blood cells fall to the bottom of a test tube, can tell the doctor if inflammation is present. Inflammation is the key sign of juvenile arthritis and a number of other conditions.
X-Rays
Your child’s doctor will order x-rays if he or she suspects injury to the bone or unusual bone development. Early in the disease, some x-rays can show changes in soft tissue. In general, x-rays are more useful later in the disease, when bones may be affected.
Other Tests
Because there are many causes of joint pain and swelling, the doctor may use other lab tests to help rule out other conditions before diagnosing juvenile arthritis. Some of these conditions include:
Physical injury.
Bacterial or viral infection.
Lyme disease.
Inflammatory bowel disease.
Lupus.
Dermatomyositis.
Some forms of cancer.
How is juvenile arthritis treated?
Doctors who treat arthritis in children will try to make sure your child can remain physically active. They also try to make sure your child can stay involved in social activities and have an overall good quality of life.
Doctors can prescribe treatments to reduce swelling, maintain joint movement, and relieve pain. They also try to prevent, identify, and treat problems that result from the arthritis. Most children with arthritis need a blend of treatments – some treatments include medicines. Drugs@FDA is a searchable catalog of FDA-approved drug products, see: https://www.accessdata.fda.gov/scripts/cder/daf.
Researchers are also trying to improve current treatments and find new medicines that will work better with fewer side effects.
Who treats juvenile arthritis?
A team approach is the best way to treat juvenile arthritis. It is best if a doctor trained to treat these types of diseases in children, called a pediatric rheumatologist, manages your child’s care. However, many children’s doctors and “adult” rheumatologists also treat children with arthritis.
Other members of your child’s health care team may include:
Physical therapist.
Occupational therapist.
Counselor or psychologist.
Eye doctor.
Dentist and orthodontist.
Bone surgeon.
Dietitian.
Pharmacist.
Social worker.
Rheumatology nurse.
School nurse.
Living with juvenile arthritis
Juvenile Arthritis Affects the Whole Family
Juvenile arthritis can strain your child’s ability to take part in social and after-school activities, and it can make schoolwork more difficult. But, all family members can help the child both physically and emotionally by:
Getting the best care possible.
Learning as much as you can about your child’s disease and its treatment.
Joining a support group.
Treating your child as normally as possible.
Encouraging exercise and physical therapy for your child.
Working closely with your child’s school.
Talking with your child about his or her condition and feelings.
Working with therapists or social workers.
Exercise Is Key to Reducing Symptoms of Juvenile Arthritis
Pain sometimes limits what children with juvenile arthritis can do. However, exercise is key to reducing the symptoms of arthritis and maintaining function and range of motion of the joints. Ask your child’s health care team for exercise guidelines.
Most children with arthritis can take part in physical activities and certain sports when their symptoms are under control. Swimming is a good activity because it uses many joints and muscles without putting weight on the joints.
During a disease flare, your child’s doctor may advise your child to limit certain activities. It will depend on the joints involved. Once the flare is over, your child can return to his or her normal activities.
Arthritis: Osteoarthritis
Points To Remember About Osteoarthritis
Osteoarthritis is a disease that damages the slippery tissue that covers the ends of bones in a joint. This allows bones to rub together, causing pain and stiffness.
Osteoarthritis occurs most often in older people. Younger people sometimes get the disease after joint injuries.
No single test can diagnose osteoarthritis. Doctors use several methods to diagnose the disease and rule out other problems.
Treatments for osteoarthritis include medicines, nondrug pain relief techniques, surgery, and alternative therapies.
Exercise, weight control, and other self-care activities can help you live with osteoarthritis.
Overview of Osteoarthritis
Osteoarthritis is the most common type of arthritis and is seen especially among older people. It is sometimes called degenerative joint disease.
A joint with severe osteoarthritis (representation)
People with osteoarthritis usually have joint pain and stiffness. The most commonly affected joints are in the hands (ends of the fingers and thumbs), neck, lower back, knees, and hips. Unlike some other forms of arthritis, osteoarthritis does not affect the skin, lungs, eyes, or blood vessels. It can also occur in only one joint or can affect a joint on one side of the body much more severely.
Osteoarthritis affects each person differently. For some people, osteoarthritis is relatively mild and interferes little with day-to-day life. For others, it causes significant pain and disability. Joint damage usually develops gradually over years, although it could worsen quickly in some people.
What happens in osteoarthritis?
Osteoarthritis damages cartilage, the tissue that covers the ends where two bones meet to form a joint. This allows the bones to rub together, causing pain, swelling, and loss of joint motion. Over time, the joint may lose its normal shape. Also, small bone growths, called osteophytes or bone spurs, may grow on the edges of the joint. Bits of bone or cartilage can also break off and float inside the joint space. This causes more pain and damage.
Who Gets Osteoarthritis?
Osteoarthritis becomes more common with age. However, younger people can also develop it, usually as the result of a joint injury, an abnormal joint structure, or a genetic defect in joint cartilage.
Before age 45, more men than women have osteoarthritis. After age 45, it is more common in women. It is also more likely to occur in people who are overweight and in those with jobs that stress particular joints.
Symptoms of Osteoarthritis
Early in the disease, your joints may ache after physical work or exercise. Later on, joint pain may become more persistent. You may also experience joint stiffness, especially when you first wake up in the morning or have been in one position for a long time.
Joints often affected by osteoarthritis include:
Hands: If your mother or grandmother has or had osteoarthritis in their hands, you’re at an increased risk of having it too. Women are more likely than men to have osteoarthritis in the hands. For most women, it develops after menopause.
Knees: Stiffness, swelling, and pain in the knees can make it hard to walk, climb, and get in and out of chairs and bathtubs. Osteoarthritis in the knees can lead to disability.
Hips: You might feel pain and stiffness in the hip joint or in the groin, inner thigh, buttocks, or even knees. Moving and bending may be limited, making daily activities such as dressing and putting on shoes a challenge.
Spine: You may feel stiffness and pain in the neck or lower back. In some cases, arthritis-related changes in the spine can cause pressure on the nerves where they exit the spinal column, resulting in weakness, tingling, or numbness of the arms and legs. In severe cases, this can even affect bladder and bowel function.
Causes of Osteoarthritis
Osteoarthritis usually happens gradually over time. Some things that might make it more likely include:
Being overweight.
Getting older.
Joint injury.
Joints that are not properly formed.
A genetic defect in joint cartilage.
Tests for Osteoarthritis
Although there is no single test for osteoarthritis, your doctor may do the following to diagnosis you with the condition:
Medical history to learn about your symptoms, any other medical problems you and your close family members have, and about any medications you are taking.
Physical exam to check your general health, reflexes, and problem joints.
Take pictures of your joint.
X-rays can show things such as cartilage loss, bone damage, and bone spurs. Early damage may not show on x-rays.
Magnetic resonance imaging (MRI) can show damage to connective tissues.
Blood tests to rule out other causes for symptoms.
Joint fluid samples to look for other causes of joint pain, such as infection or gout.
Treatment of Osteoarthritis
Treatment for osteoarthritis can include medications or surgery to reduce pain and improve functioning.
Medications commonly used in treating osteoarthritis include:
Over-the-counter pain relievers such as acetaminophen.
Nonsteroidal anti-inflammatory drugs (NSAIDs) to treat pain and inflammation. Ibuprofen and naproxen sodium, are available over the counter, whereas other NSAIDS are available by prescription only.
Creams, rubs or sprays that are applied to the skin over sore joints to relieve pain.
Prescription opioid pain relievers are sometimes prescribed when over-the-counter medications don't work or a person may not be able to take NSAIDs.
Corticosteroids are strong inflammation-fighting drugs that can be injected into the joint to temporarily relive pain. This type of treatment is usually not recommended for more than two to four treatments per year. These types of drugs are not typically given by mouth to treat osteoarthritis, unless treating inflammatory flares.
Hyaluronic acid substitutes (viscosupplements) are injected into the knee to replace a normal component of the joint involved in lubrication and nutrition.
Surgery may be a factor after considering a variety of factors, including your age, occupation, level of disability, pain intensity, and the degree to which arthritis interferes with your lifestyle. Surgeries can include one or more of the following:
Arthroscopic debridement: Removal of loose pieces of bone and cartilage from the joint.
Osteotomy: Repositioning of bones.
Joint resurfacing:Smoothing out bones.
Prostheses are artificial joints that replace affected joints. The artificial joints can be made from metals, high-density plastic, or ceramic material. Artificial joints can last 10 to 15 years or longer. In some cases, your surgeon may replace only the damaged part of the knee joint, leaving undamaged parts of the joint in place.
Transcutaneous electrical nerve stimulation (TENS) directs mild electric pulses to nerve endings that lie beneath the skin in the painful area. It seems to work by blocking pain messages to the brain and by changing pain perception.
Alternative therapies for osteoarthritis can include:
Massage can increase blood flow and bring warmth to a stressed area. However, arthritis-stressed joints are sensitive, so the therapist must be familiar with the problems of the disease.
Acupuncture uses thin needles to relieve pain and restore health. Scientists think the needles stimulate the release of natural, pain-relieving chemicals produced by the nervous system.
Who Treats Osteoarthritis?
Treating osteoarthritis requires a team effort involving you and several types of health care professionals. These may include:
Primary care doctors, such as a family physician or internal medicine specialist, who coordinates care between the different health providers and treats other problems as they arise.
Rheumatologists, who specialize in arthritis and other diseases of the bones, joints, and muscles.
Orthopaedists, who specialize in treatment and surgery for bone and joint diseases.
Physical therapists, who help improve joint function.
Occupational therapists, who teach ways to protect joints, minimize pain, perform activities of daily living, and conserve energy.
Dietitians, who teach about good diets and maintaining a healthy weight.
Nurse educators, who help you understand your condition and help start treatment plans.
Physiatrists (rehabilitation specialists), who supervise exercise programs.
Licensed acupuncture therapists, who reduce pain and improve physical functioning by inserting fine needles into the skin at specific points on the body.
Psychologists or social workers, who help with social challenges caused by medical conditions.
Chiropractors, who focus treatment on the relationship between the body's structure, mainly the spine, and its functioning.
Massage therapists, who press, rub, and otherwise manipulate the muscles and other soft tissues of the body.
Living With Osteoarthritis
There are many things you can do to help you live with osteoarthritis, including:
Exercise can reduce joint pain and stiffness and increase flexibility, muscle strength, and endurance. Exercise also helps people lose weight, which reduces stress on painful joints. You should speak to your doctor about a safe, well-rounded exercise program, which could include:
Strengthening exercises: Performed by weights or exercise bands to strengthen muscles that support joints affected by arthritis.
Aerobic activities: Exercises that keep your lungs and circulatory system healthy. Examples include brisk walking or low-impact aerobics.
Range-of-motion activities keep your joints limber.
Balance and agility exercises help you maintain daily living skills.
Weight control: If overweight, losing weight can reduce stress on joints, limit further injury, increase mobility, and reduce the risk of associated health problems. A healthy diet and regular exercise help reduce weight.
Heat and cold therapies can reduce joint pain. Heat therapy increases blood flow, tolerance for pain, and flexibility. Cold therapy numbs the nerves around the joint to reduce pain and may relieve inflammation.
Nutritional supplements such as glucosamine and chondroitin sulfate have been reported to improve symptoms in some people with osteoarthritis, as have certain vitamins.
Research Progress Related to Osteoarthritis
Recent research on osteoarthritis has focused on:
Immune system: People with osteoarthritis have increased activation of the complement system, a major part of the immune system. Researchers are using animal models to explore whether blocking this system might help treat osteoarthritis.
Biomarkers: Data from osteoarthritis patients will help understand how certain risk factors are linked to development and worsening of knee osteoarthritis.
Diagnosis: Scientists are exploring ways to detect cartilage changes that could eventually enable doctors to diagnose osteoarthritis long before traditional x-rays would show damage.
Medications: Researchers are looking for drugs that would prevent, slow down, or reverse joint damage.
Complementary and alternative therapies: The Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT), found that the combination of glucosamine and chondroitin sulfate provided pain relief in some patients.
Healing joint injuries and cartilage damage: Researchers are exploring ways to heal the knee’s anterior cruciate ligament (ACL), to avoid surgery. Other scientists are looking for ways to patch damaged cartilage.
Genetics: Scientists have identified a gene defect in an inherited type of osteoarthritis. This gene defect affects an important part of cartilage, making it more likely that the cartilage will break or tear more easily under stress.
Patient education and self-management: Researchers are investigating a variety of self-management approaches in people with osteoarthritis, including coping skills training, exercise training, patient education, and social support. These strategies have shown some success in managing pain and improving function.
Exercise and weight reduction: Studies have shown that losing extra weight can help people who already have osteoarthritis. Moreover, overweight or obese people who do not have osteoarthritis may reduce their risk of developing the disease by losing weight.
Arthritis: Psoriatic Arthritis
What is psoriatic arthritis?
Points To Remember About Psoriatic Arthritis
Psoriatic arthritis can occur in people who have psoriasis (scaly red and white skin patches).
It affects the joints and areas where tissues attach to bone.
No one knows what causes psoriatic arthritis. Researchers believe that both genes and environment are involved.
Medications are used to treat symptoms of psoriatic arthritis. You should talk to your doctor about the best medications for you.
Exercise, heat and cold therapies, relaxation exercises, splints and braces, and assistive devices can help.
Psoriatic arthritis can occur in people who have psoriasis (scaly red and white skin patches). It affects the joints and areas where tissues attach to bone.
The joints most often affected are:
The outer joints of the fingers or toes.
Wrists.
Knees.
Ankles.
Lower back.
Who gets psoriatic arthritis?
Anyone with psoriasis (scaly red and white skin patches) can have psoriatic arthritis.
It is more common in whites than in African Americans or Asian Americans. The disease typically begins between the ages of 30 and 50, but can begin in childhood .
What are the symptoms of psoriatic arthritis?
Symptoms of psoriatic arthritis include:
Joint pain and swelling that may come and go. Joints may also be red and warm.
Tenderness in the heel and bottom of the foot.
Pain and stiffness in the neck and lower back.
Joint stiffness, especially in the morning.
Painful, sausage-like swelling of the fingers and/or toes.
Thickness and reddening of the skin with flaky, silver white patches called scales.
Pitting of the nails or separation from the nail bed.
Tiredness.
Pink eye or other eye infections.
What causes psoriatic arthritis?
No one knows what causes psoriatic arthritis. Researchers believe that both genes and environment are involved.
Is there a test for psoriatic arthritis?
If you have psoriasis and start to develop joint pain, it’s important to see your doctor. Early diagnosis and treatment of psoriatic arthritis can help prevent joint damage.
Although there is no test for psoriatic arthritis, your doctor may do the following to diagnosis you with the condition:
Ask you about your medical and family history.
Give you a physical exam.
Take samples of blood or joint fluid for a laboratory test.
Take x-rays.
How is psoriatic arthritis treated?
Psoriatic arthritis is treated by medications. The type of medication depends on how severe the disease is.
Who treats psoriatic arthritis?
Doctors who diagnose and treat psoriatic arthritis include:
A general practitioner, such as your family doctor.
A rheumatologist, who treats arthritis and other diseases of the bones, joints, and muscles.
Arthritis: Rheumatoid Arthritis
Points To Remember About Rheumatoid Arthritis
Rheumatoid arthritis is a disease that causes pain, swelling, and stiffness in your joints. This disease often occurs in more than one joint and can affect any joint in the body. If you have this disease, you may feel sick and tired, and sometimes get fevers.
Anyone can get rheumatoid arthritis, but it occurs more often in women and is most common in older people.
Genes, environmental factors, and hormones may play roles in the development of rheumatoid arthritis.
Treatment may involve medicine, surgery, and alternative therapies.
Regular rest, joint care, activity, a healthy diet, and reduced stress can ease symptoms.
What is rheumatoid arthritis?
Rheumatoid arthritis is a disease that affects your joints. Joints are where two or more bones join together, such as at your knees, hips, or shoulders. Rheumatoid arthritis causes pain, swelling, and stiffness. If joints on one side of your body have rheumatoid arthritis, usually those joints on the other side do too. This disease often occurs in more than one joint. It can affect any joint in the body.
If you have this disease, you also may feel sick and tired, and sometimes get fevers.
Who gets rheumatoid arthritis?
Anyone can get this disease, though it occurs more often in women. Rheumatoid arthritis often starts in middle age and is common in older people. But children and young adults can also get it.
What are the symptoms of rheumatoid arthritis?
Symptoms of rheumatoid arthritis, which can range from mild to severe, include:
Tender, warm, swollen joints.
Swollen joints on both sides of the body, such as in both your right and left wrist.
Swollen joints often in the wrist and finger joints closest to the hand.
Swollen joints sometimes in other joints, including the neck, shoulders, elbows, hips, knees, ankles, and feet.
Feeling tired and having low energy.
Fevers.
Pain and stiffness lasting for more than 30 minutes in the morning or after a long rest.
Symptoms that last for many years.
What causes rheumatoid arthritis?
Doctors don't know the exact cause of rheumatoid arthritis. They know that with this type of arthritis, a person's immune system attacks his or her own body tissues. The immune system normally attacks invaders to the body, such as a cold virus or bacteria. Researchers are learning many things about why and how this happens. Things that may cause rheumatoid arthritis are:
Genes (passed from parent to child).
Environmental factors.
Hormones.
Is there a test for rheumatoid arthritis?
Rheumatoid arthritis can be hard to diagnose because:
There is no single test for the disease.
The symptoms can be the same as in other kinds of joint disease.
The full symptoms can take time to develop.
To diagnose rheumatoid arthritis, doctors use medical history, a physical exam, x-rays and other imaging tests, and lab tests.
How is rheumatoid arthritis treated?
Doctors have many ways to treat rheumatoid arthritis. Treatment may involve:
Medicine.
Surgery.
Regular doctor visits.
Complementary therapies.
The goals of treatment are to:
Take away pain.
Reduce swelling.
Slow down or stop joint damage.
Help you feel better.
Help you stay active.
Medicine
Most people with rheumatoid arthritis take medicine. Drugs can be used for pain relief, to reduce swelling, and to stop the disease from getting worse. What a doctor prescribes depends on:
Your general health.
How serious the rheumatoid arthritis is.
How serious the rheumatoid arthritis may become.
How long you will take the drug.
How well the drug works.
Possible side effects.
How is it treated?
Surgery
There are many kinds of surgery for people with a lot of joint damage. Surgery may:
Reduce your pain.
Help your joint work better.
Help you be able to do daily activities.
Surgery is not for everyone. Talk with your doctor to decide what is best for you.
Regular Doctor Visits
Regular medical care is important so doctors can:
See if the disease is getting worse.
See if drugs are helping.
Discuss any drug side effects.
Change treatment when needed.
Complementary Therapies
Special diets, vitamins, and other complementary therapies are sometimes suggested to treat rheumatoid arthritis.
Many of these treatments are not harmful, but they may not be well tested or have any real benefits.
Ask your doctor about things you can do to manage your pain, such as exercise programs, support groups, and education classes. Before starting any complementary therapy, talk with your doctor to make sure it isn’t harmful.
Who treats rheumatoid arthritis?
Several types of health care professionals may treat you, including:
Internist, who diagnoses and treats adults.
Rheumatologist, who treats arthritis and other disease of the bones, joints, and muscles.
Orthopaedists, who treat and perform surgery for bone and joint diseases.
Physical therapists, who help to improve joint function.
Occupational therapists, who teach ways to protect joints, reduce pain, perform activities of daily living, and conserve energy.
Dietitians, who teach ways to use a good diet to improve health and maintain a healthy weight.
Living with rheumatoid arthritis
With rheumatoid arthritis, you can still lead a full life. Besides going to your doctor and therapists regularly, you can also do these activities to help reduce your symptoms.
Joint Care
Look for ways to reduce stress on your joints. Some people find wearing a splint around a painful joint for a short time helps. Talk with your doctor to see if a splint may work for you. In addition, some special equipment can help such as a zipper puller or long-handled shoe horn.
Rest
Keep a good balance between rest and activity. Try to take frequent breaks, especially when your symptoms are bothering you.
Lowering Stress
Try to lower your stress by taking the time to relax, doing hobbies you enjoy, or joining a support group. Support groups can reduce your stress by helping you to:
Learn about the disease.
Cope with your emotions about your symptoms.
Feel more control over the disease.
Build confidence.
A Healthy Diet
Eat a healthy diet which will help you manage your weight and get a variety of nutrients for overall health.
Other medical problems related to rheumatoid arthritis
You may also experience other health problems as a result of your rheumatoid arthritis. Be sure to talk with your doctor if any of these occur.
Many people with rheumatoid arthritis may also have:
Anemia, a condition in which your blood has a lower than normal count of red blood cells.
Depression.
Anxiety.
Other effects that occur less often include:
Neck pain.
Dry eyes.
Dry mouth.
Very rarely, people may have inflammation of their:
Blood vessels.
Lining of the lungs.
Sac enclosing the heart.
What People With Rheumatoid Arthritis Need to Know About Osteoporosis
What Is Rheumatoid Arthritis?
Rheumatoid arthritis is an autoimmune disease, a disorder in which the body attacks its own healthy cells and tissues. When someone has rheumatoid arthritis, the membranes around his or her joints become inflamed and release enzymes that cause the surrounding cartilage and bone to wear away. In severe cases, other tissues and body organs also can be affected.
Individuals with rheumatoid arthritis often experience pain, swelling, and stiffness in their joints, especially those in the hands and feet. Motion can be limited in the affected joints, curtailing one’s ability to accomplish even the most basic everyday tasks. About one-quarter of those with rheumatoid arthritis develop nodules (bumps) that grow under the skin, usually close to the joints. Fatigue, anemia (low red blood cell count), neck pain, and dry eyes and dry mouth also can occur in individuals with the disease.
Scientists estimate that about 1.5 million people in the United States have rheumatoid arthritis.1 The disease occurs in all racial and ethnic groups, but affects two to three times as many women as men. Rheumatoid arthritis is more commonly found in older individuals, although the disease typically begins in middle age. Children and young adults can also be affected.
1Helmick CG, Felson DT, Lawrence RC, Gabriel S, Hirsch R, Kwoh CK, et al.; National Arthritis Data Workgroup. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part I. Arthritis and Rheumatism, 58(1): 15–25, January 2008.
What Is Osteoporosis?
Osteoporosis is a condition in which the bones become less dense and more likely to fracture. Fractures from osteoporosis can result in significant pain and disability. In the United States, more than 53 million people either already have osteoporosis or are at high risk due to low bone mass.
Risk factors for developing osteoporosis include:
thinness or small frame
family history of the disease
being postmenopausal and particularly having had early menopause
abnormal absence of menstrual periods (amenorrhea)
prolonged use of certain medications, such as those used to treat lupus, asthma, thyroid deficiencies, and seizures
low calcium intake
lack of physical activity
smoking
excessive alcohol intake
Osteoporosis often can be prevented. It is known as a silent disease because, if undetected, bone loss can progress for many years without symptoms until a fracture occurs. Osteoporosis has been called a childhood disease with old age consequences because building healthy bones in youth helps prevent osteoporosis and fractures later in life. However, it is never too late to adopt new habits for healthy bones.
The Link Between Rheumatoid Arthritis and Osteoporosis
Studies have found an increased risk of bone loss and fracture in individuals with rheumatoid arthritis. People with rheumatoid arthritis are at increased risk for osteoporosis for many reasons. To begin with, the glucocorticoid medications often prescribed for the treatment of rheumatoid arthritis can trigger significant bone loss. In addition, pain and loss of joint function caused by the disease can result in inactivity, further increasing osteoporosis risk. Studies also show that bone loss in rheumatoid arthritis may occur as a direct result of the disease. The bone loss is most pronounced in areas immediately surrounding the affected joints. Of concern is the fact that women, a group already at increased risk for osteoporosis, are two to three times more likely than men to have rheumatoid arthritis as well.
Osteoporosis Management Strategies
Strategies for preventing and treating osteoporosis in people with rheumatoid arthritis are not significantly different from the strategies for those who do not have the disease.
Nutrition. A well-balanced diet rich in calcium and vitamin D is important for healthy bones. Good sources of calcium include low-fat dairy products; dark green, leafy vegetables; and calcium-fortified foods and beverages. Supplements can help ensure that you get adequate amounts of calcium each day, especially in people with a proven milk allergy. The Institute of Medicine recommends a daily calcium intake of 1,000 mg (milligrams) for men and women up to age 50. Women over age 50 and men over age 70 should increase their intake to 1,200 mg daily.
Vitamin D plays an important role in calcium absorption and bone health. Food sources of vitamin D include egg yolks, saltwater fish, and liver. Many people, especially those who are older, may need vitamin D supplements to achieve the recommended intake of 600 to 800 IU (International Units) each day.
Exercise. Like muscle, bone is living tissue that responds to exercise by becoming stronger. The best activity for your bones is weight-bearing exercise that forces you to work against gravity. Some examples include walking, climbing stairs, weight training, and dancing.
Exercising can be challenging for people with rheumatoid arthritis, and it needs to be balanced with rest when the disease is active. However, regular exercise, such as walking, can help prevent bone loss and, by enhancing balance and flexibility, can reduce the likelihood of falling and breaking a bone. Exercise is also important for preserving joint mobility.
Healthy lifestyle. Smoking is bad for bones as well as the heart and lungs. Women who smoke tend to go through menopause earlier, resulting in earlier reduction in levels of the bone-preserving hormone estrogen and triggering earlier bone loss. In addition, smokers may absorb less calcium from their diets. Alcohol also can have a negative effect on bone health. Those who drink heavily are more prone to bone loss and fracture, because of both poor nutrition and increased risk of falling.
Bone density test. A bone mineral density (BMD) test measures bone density in various parts of the body. This safe and painless test can detect osteoporosis before a fracture occurs and can predict one’s chances of fracturing in the future. The BMD test can help determine whether medication should be considered. People with rheumatoid arthritis, particularly those who have been receiving glucocorticoid therapy for 2 months or more, should talk to their doctor about whether a BMD test is appropriate.
Medication. Like rheumatoid arthritis, osteoporosis has no cure. However, medications are available to prevent and treat osteoporosis. Several medications are available for people with rheumatoid arthritis who have or are at risk for glucocorticoid-induced osteoporosis.
The NIH Osteoporosis and Related Bone Diseases ~ National Resource Center is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases with contributions from:
Reactive arthritis is a type of spondyloarthritis, a group of disorders that can cause inflammation throughout the body (especially in the spine). Reactive arthritis is associated with inflammation of the joints, eyes, and urinary tract and its associated genital structures. These symptoms may occur alone, together, or not at all. Any of these symptoms may be so mild that you may not notice them.
The symptoms of reactive arthritis usually last several months, although symptoms can return or develop into a long-term disease in a small percentage of people.
Reactive arthritis is not contagious; that is, a person with the disorder cannot pass the arthritis on to someone else. However, the bacteria that can trigger reactive arthritis can be passed from person to person.
Most people with reactive arthritis recover fully from the initial flare of symptoms. They may have mild arthritis symptoms that last up to a year, although symptoms don’t usually interfere with daily activities. Some people will have long-term, mild arthritis. A few patients will have long-term, severe arthritis that is difficult to control with treatment and may cause joint damage.
Some patients will re-develop symptoms, such as back pain and arthritis, after the initial flare has disappeared. These relapses may be caused by reinfection.
What happens in reactive arthritis?
In many patients, reactive arthritis is triggered by an infection in the bladder, urethra, or vagina that is often transmitted through sexual contact. Another form of reactive arthritis is caused by an intestinal infection from eating food or handling substances that are contaminated with bacteria.
Points To Remember About Reactive Arthritis
Reactive arthritis is pain or swelling in a joint caused by an infection in your body. You may also have red, swollen eyes and a swollen urinary tract.
Doctors may use a combination of tests to confirm that you have reactive arthritis.
Symptoms are usually treated with medications that reduce inflammation, fight infection, and stop your immune system from attacking its own tissues.
Exercise can reduce joint pain and stiffness. It can also help you lose weight to reduce stress on joints.
Who gets reactive arthritis?
Men between ages 20 and 40 are most likely to get reactive arthritis. Men are also more likely than women to get the form that is caused by a bacteria passed along during sex. Women and men are at equal risk of getting the disease because of bacteria in food. Women with reactive arthritis often have milder symptoms than men.
Symptoms of Reactive Arthritis
Symptoms of reactive arthritis can include:
Joint symptoms, including:
Pain and swelling in the knees, ankles, and feet. Wrists, fingers, and other joints are affected less often.
Inflammation of the tendons or at places where tendons attach to the bone.
Heel spurs, which are bony growths in the heel that may cause long-lasting foot pain.
Low-back and buttock pain.
Inflammation of the bones in the spinal column or where the spine connects to the pelvis.
Inflammation of the urinary and genital tract.
Eye symptoms, including:
Inflammation.
Redness.
Pain and irritation.
Blurred vision.
Mouth sores and skin rashes
Causes of Reactive Arthritis
In many patients, reactive arthritis is triggered by a bacterial infection in the bladder, urethra, or vagina that is often transmitted through sexual contact. Another form of reactive arthritis is caused by an intestinal infection from eating food or handling substances that are contaminated with bacteria. Reactive arthritis typically begins within two to four weeks after infection.
Doctors do not know exactly why some people exposed to these bacteria develop reactive arthritis and others do not. One gene, human leukocyte antigen (HLA) B27, increases a person’s chance of developing reactive arthritis. However, inheriting the HLA B27 gene does not necessarily mean you will get reactive arthritis.
A person with the disorder cannot pass the arthritis on to someone else. However, the bacteria that can trigger reactive arthritis can be passed from person to person.
Is there a test for reactive arthritis?
There is no specific lab test to confirm that you have reactive arthritis. Doctors sometimes find it difficult to diagnose. Tests the doctor may order include:
Complete medical history.
Blood tests.
Tests for infections.
X-rays.
Diagnosis of Reactive Arthritis
Although there is no single test for reactive arthritis, your doctor may do the following to diagnosis you with the condition:
Medical history to learn about your symptoms and any previous medical problems or infections.
Blood tests to:
Detect the genetic factor HLA B27. A positive result does not always mean that you the disorder.
Confirm inflammation somewhere in the body.
Rule out other conditions.
Take samples from the throat, urethra, cervix, urine, stool, or joints to test for bacteria.
X-rays to help diagnose reactive arthritis and to rule out other causes of arthritis.
Treatment of Reactive Arthritis
Although there is no cure for reactive arthritis, certain medications can relieve symptoms of the disorder:
Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to treat pain and inflammation. Ibuprofen and naproxen sodium are available over the counter, whereas other NSAIDS are available by prescription only.
Corticosteroids, strong inflammation-fighting drugs, may be applied directly on skin ulcers, or injected into a joint to temporarily relieve pain. Because they are potent drugs, your doctor will seek the lowest dose required to achieve the desired benefit.
Antibiotics eliminate the bacterial infection that triggered reactive arthritis.
Immunosuppressive medicines or biologics to stop the immune system from attacking the tissues.
Who Treats Reactive Arthritis?
Diagnosing and treating reactive arthritis requires a team effort involving you and several types of health care professionals. These may include:
Rheumatologists, who specialize in arthritis and other diseases of the bones, joints, and muscles. Your rheumatologist will also coordinate care between the different health providers.
Ophthalmologists, who treat eye disease.
Urologists or gynecologists, who treat genital symptoms.
Dermatologists, who treat skin symptoms.
Orthopaedists, who perform surgery on severely damaged joints.
Physiatrists, who supervise exercise regimens.
Living With Reactive Arthritis
Exercise can reduce joint pain and stiffness and increase flexibility, muscle strength, and endurance. Exercise also helps people lose weight, which reduces stress on painful joints. You should speak to your doctor about a safe, well-rounded exercise program, which could include:
Strengthening exercises can be performed with weights or exercise bands to strengthen muscles that support joints affected by arthritis.
Muscle tightening exercises do not move any joints, so they can be done even when you have inflammation and pain.
Range-of-motion activities improve movement and flexibility and reduce joint stiffness.
Exercises to stretch the back and aquatic exercises can help if you have spine pain or inflammation.
Research Progress Related to Reactive Arthritis
Researchers continue to investigate the causes of reactive arthritis and study treatments for the condition. Recent research has explored:
The relationship between infection and reactive arthritis: Researchers are trying to better understand why an infection triggers arthritis and why this only occurs in some people. Scientists also are studying why people with the genetic factor HLA B27 are more at risk than others.
Locating the triggering bacteria in the body: Some scientists suspect that bacteria travel to the joints, where they can remain in small amounts over long periods of time.
Combination treatments, such as antibiotics in combination with immunosuppressant medicines.
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This publication contains information about medications used to treat the health condition discussed here. When this publication was developed, we included the most up-to-date (accurate) information available.
