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A r t h r i t i s

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  Arthritis Index            
  Joint Inflammation
Causes, incidence, and risk factors
Joint inflammation may result from
Symptoms
Signs and tests
Treatment
 

 

Lifestyle Changes
Medicines
Prescription Medicines
Surgery And Other Treatments
 
  Expectations (prognosis)
ComplicationsCalling your health care provider
Prevention

References

 

Arthrogryposis
Arthrogryposis
Diagnosis
Symptoms
Causes
Treatment
Pictures

   
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Joint inflammation
Last reviewed: March 22, 2013.
Arthritis is inflammation of one or more joints. A joint is the area where two bones meet. There are over 100 different types of arthritis.
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Causes, incidence, and risk factors
Arthritis involves the breakdown of cartilage. Cartilage normally protects a joint, allowing it to move smoothly. Cartilage also absorbs shock when pressure is placed on the joint, such as when you walk. Without the normal amount of cartilage, the bones rub together, causing pain, swelling (inflammation), and stiffness   Arthritis pic
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Joint inflammation may result from:
  • An autoimmune disease (the body's immune system mistakenly attacks healthy tissue)
  • Broken bone
  • General "wear and tear" on joints
  • Infection, usually by bacteria or virus
  Joints
Usually the joint inflammation goes away after the cause goes away or is treated. Sometimes it does not. When this happens, you have chronic arthritis. Arthritis may occur in men or women. Osteoarthritis is the most common type. 
Other, more common types of arthritis include:
 
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Symptoms
Arthritis causes joint pain, swelling, stiffness, and limited movement. Symptoms can include:
  • Joint pain
  • Joint swelling
  • Reduced ability to move the joint
  • Redness of the skin around a joint
  • Stiffness, especially in the morning
  • Warmth around a joint
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Signs and tests

The health care provider will perform a physical exam and ask questions about your medical history.

The physical exam may show:

 
  • Fluid around a joint
  • Warm, red, tender joints
  • Difficulty moving a joint (called "limited range of motion")
 

Some types of arthritis may cause joint deformity. This may be a sign of severe, untreated rheumatoid arthritis. Blood tests and joint x-rays are often done to check for infection and other causes of arthritis.Your doctor may also remove a sample of joint fluid with a needle and send it to a lab to be checked.

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Treatment
The goal of treatment is to reduce pain, improve function, and prevent further joint damage. The underlying cause often cannot be cured.

Lifestyle Changes

Lifestyle changes are the preferred treatment for osteoarthritis and other types of joint swelling. Exercise can help relieve stiffness, reduce pain and fatigue, and improve muscle and bone strength. Your health care team can help you design an exercise program that is best for you.Exercise programs may include:
  • Low-impact aerobic activity (also called endurance exercise)
  • Range of motion exercises for flexibility
  • Strength training for muscle tone
Your health care provider may suggest physical therapy. This might include:
  • Heat or ice
  • Splints or orthotics to support joints and help improve their position; this is often needed for rheumatoid arthritis
  • Water therapy
  • Massage
Other things you can do include:
  • Get plenty of sleep. Sleeping 8 to 10 hours a night and taking naps during the day can help you recover from a flare-up more quickly and may even help prevent flare ups.
  • Avoid staying in one position for too long.
  • Avoid positions or movements that place extra stress on your sore joints.
  • Change your home to make activities easier. For example, install grab bars in the shower, the tub, and near the toilet.
  • Try stress-reducing activities, such as meditation, yoga, or tai chi.
  • Eat a healthy diet full of fruits and vegetables, which contain important vitamins and minerals, especially vitamin E.
  • Eat foods rich in omega-3 fatty acids, such as cold water fish (salmon, mackerel, and herring), flaxseed, rapeseed (canola) oil, soybeans, soybean oil, pumpkin seeds, and walnuts.
  • Apply capsaicin cream over your painful joints. You may feel improvement after applying the cream for 3-7 days.
  • Lose weight, if you are overweight. Weight loss can greatly improve joint pain in the legs and feet.
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Medicines
  • Medicines may be prescribed along with lifestyle changes. All medicines have some risks. You should be closely followed by a doctor when taking arthritis medicines.
Over-the-counter medicines:
  • Acetaminophen (Tylenol) is usually tried first. Take up to 4 grams a day (two arthritis-strength Tylenol every 8 hours). Do not take more than the recommended dose or take the drug along with a lot of alcohol. Doing so may damage your your liver.
  • Aspirin, ibuprofen, or naproxen are nonsteroidal anti-inflammatory drugs (NSAIDs) that can relieve arthritis pain. However, they can carry risks when used for a long time. Possible side effects include heart attack, stroke, stomach ulcers, bleeding from the digestive tract, and kidney damage.
Prescription Medicines:
It is very important to take your medicines as directed by your doctor. If you are having problems doing so (for example, because of side effects), you should talk to your doctor. Also make sure your doctor knows about all the medicines you are taking, including vitamins and supplements bought without a prescription.
SURGERY AND OTHER TREATMENTS
In some cases, surgery may be done if other treatments have not worked. This may include:
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Expectations (prognosis)
A few arthritis-related disorders can be completely cured with proper treatment. Most forms of arthritis however are long-term (chronic) conditions.
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Complications
Complications of arthritis include:
  • Long-term (chronic) pain
  • Disability
  • Difficulty performing daily activities
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Calling your health care provider

Call your doctor if:

  • Your joint pain persists beyond 3 days.
  • You have severe unexplained joint pain.
  • The affected joint is significantly swollen.
  • You have a hard time moving the joint.
  • Your skin around the joint is red or hot to the touch.
  • You have a fever or have lost weight unintentionally.
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Prevention

Early diagnosis and treatment can help prevent joint damage. If you have a family history of arthritis, tell your doctor, even if you do not have joint pain. Avoiding excessive, repeated motions may help protect you against osteoarthritis.

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References
  1. Hunter DJ, Lo GH. The management of osteoarthritis: an overview and call to appropriate conservative treatment. Med Clin North Am. 2009;93:127-43, xi. [PubMed]
  2. Huizinga TW, Pincus T. In the clinic. Rheumatoid arthritis. Ann Intern Med. 2010 Jul 6;153(1):ITC1-1-ITC1-15. [PubMed]
  3. Neustadt DH. Osteoarthritis. In: Bope ET, Kellerman RD, eds. Conn’s Current Therapy 2013. 1st ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 9.
  4. O’Dell JR. Treatment of Rheumatoid Arthritis. In: Firestein GS, Budd RC, Gabriel SE, et al, eds. Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, Pa: Saunders Elsevier;2012:chap 71.

Review Date: 3/22/2013.

Reviewed by: Ariel D. Teitel, MD, MBA, Clinical Associate Professor of Medicine, NYU Langone Medical Center. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.

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Arthrogryposis

Arthrogryposis is a congenital birth condition that is marked by multiple joint contractures in the body. One in 3,000 children will have this problem and it develops both in boys and girls. It is a neuro-muscular skeletal disorder affecting all parts of the body and in medical terms it is described as “arthrogryposis multiplex congenital”. There would be stiffness and poor movement of the joints and muscles. Here the joint remains in the form of curved position and is inherited by birth. The disorder is progressive and nothing much can be done to prevent it.

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Diagnoses:

This disorder can be identified by routine ultrasound scan or CT scan of the child to detect the extent of abnormality in the joints and central nervous system.

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Symptoms :

The symptoms are different in each child depending on the severity of the problem caused during the fetal development. The arms and legs are badly affected and the ankles and wrists of the child looks deformed. For some children, there would be very less or even no movement of joints in the arms and legs. Muscular growth in those regions are almost absent for affected children. The hip joint will not be fixed in proper place.

The spinal cord may look curvy and the child may have deformity in his face and genitals. In addition, the child may suffer from acute respiratory problem and cardiac problem by birth.

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Causes:

The major cause for this condition is the reduced movement of the fetus inside the womb. The fetus should make flexible movements inside the mother’s uterus for normal development of joints and muscles. However some reason prevents the fetus movement leading to contracture of joints and muscles. There would be an extra tissue around the joint of the baby that forms during 8th to 10th week of pregnancy and it is what restricts the movements of the joint.

Any malfunction during the development of central nervous system of brain causes this disorder in the child. Myotonic dystrophy, spinal muscular atrophy and severe infections like measles during pregnancy can be the reason for arthrogryposis.

Consumption of alcohol and drugs that are poisonous to the child’s development can also cause this problem. If the mother had fever for long time during her pregnancy it would increase body temperature and will leave the fetus get soaked in hot tub (inside the womb) for prolonged time.

Due to neuropathic processes, the baby’s nerve may not mature enough for normal functioning which may cause this disorder. Sometimes, due to improper circulation of the blood inside the fetus body the nerves may not receive enough nourishment which may account for poor muscle development or deformed muscles and joints.

Arthrogryposis can happen if there is not adequate amount of amniotic fluid facilitating free movement of the fetus.

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Treatment:

Since the disorder is congenital (inherited by birth) there is no way one can prevent this problem. Soon after birth, the affected child should be given regular physical therapy for stretching and contracting the joints so that the muscles become strong. Effective physiotherapy is useful for strengthening the muscles and repositioning the child’s limbs and arms. The baby is to given such therapies during the first 4 months period wherein the contractures would loosen rapidly giving way for strengthened joints and muscles.

Occupational therapy is given for the child to use the available motor functions in effective ways. Doctors would advice using splints for stretching the joints and the child should wear it day and night.

In severe cases, orthopedic surgery is done for correcting the joint problem to some extent. The child having club foot or hernia or hip displacement problem will be cured through proper surgeries.

For repairing congenital heart disease, corrective surgery is done on the heart.

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Pictures of Arthrogryposis:

     Pic 1      Pic 2        Pic 3        Pic 4

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