Patient education: Arthritis (Beyond the Basics)

Author:: Robert H Shmerling, MD
Section Editor:: E William St Clair, MD
Deputy Editor:: Philip Seo, MD, MHS

Literature review current through: Jan 2024.

This topic last updated: Apr 14, 2023.

Please read the Disclaimer at the end of this page.

ARTHRITIS OVERVIEW — Arthritis refers to inflammation of a joint. The inflammation can affect any of the important structures inside a joint, including the joint lining (synovium), bones, cartilage, or supporting tissues. Common symptoms of arthritis include pain, stiffness, and swelling of the joint. The condition may affect one, a few, or many joints throughout the body.

There are many possible causes of arthritis, although some are much more common than others. Some types of arthritis respond well to treatment and resolve without any lingering effects, whereas other types of arthritis are more difficult to control and can be disabling.

This topic provides an overview of arthritis; more detailed information about the various types of arthritis is also available. (See 'Where to get more information' below.)

ARTHRITIS CAUSES — There are many possible causes of arthritis, including age-related wear and tear, infections, autoimmune conditions, injuries, and others. Topic reviews that discuss specific types of arthritis are available separately. (See 'Where to get more information' below.)

ARTHRITIS SYMPTOMS

Joint symptoms — The most common symptoms of arthritis include joint pain and stiffness. There may also be joint tenderness, swelling, and limited movement of one or more joints. The skin over the joint is sometimes red and warm.

There are two main types of arthritis: inflammatory and noninflammatory. Examples of inflammatory arthritis include infectious arthritis, rheumatoid arthritis, and gout. An example of noninflammatory arthritis is osteoarthritis, the most common type of arthritis. The location and pattern of joint pain, the presence or absence of joint swelling, the rapidity of its onset, as well as the presence of signs and symptoms outside the joint (such as rash), can help to distinguish between inflammatory and noninflammatory arthritis.

Inflammatory arthritis — Inflammatory arthritis usually causes joint stiffness with rest, especially morning stiffness. Certain types of inflammatory arthritis, such as rheumatoid arthritis and the arthritis of systemic lupus erythematosus (SLE), affect joints symmetrically (ie, affect the same joints on both sides of the body).

Noninflammatory arthritis — Noninflammatory arthritis usually causes pain that is aggravated by movement and weightbearing and is relieved by rest. Joints on one or both sides of the body may be affected.

ARTHRITIS DIAGNOSIS — The process of diagnosing arthritis involves several steps. A medical history and physical examination usually provide the most helpful information; laboratory tests (such as blood and urine tests), imaging tests (such as x-rays), and other tests are sometimes needed.

Laboratory and imaging tests — Laboratory and imaging tests may be needed to determine the cause of arthritis.

For example, if rheumatoid arthritis or systemic lupus erythematosus (SLE) is suspected, it can be helpful to test the blood for antibodies that are commonly present in these diseases. Examples include the rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) antibodies for rheumatoid arthritis and the antinuclear antibody (ANA) for SLE.

Testing of the fluid inside a joint, called the synovial fluid, is often helpful to determine the cause of a person's arthritis. After making the skin numb, the fluid is removed by inserting a needle inside the joint and withdrawing a sample of fluid. This procedure is called "arthrocentesis" or "joint aspiration," although it is often referred to as a "joint tap." Analysis of the joint fluid is particularly helpful in confirming that the arthritis is inflammatory and in establishing if the joint is infected (septic arthritis) or if crystals are present (gout or pseudogout).

X-rays provide detailed pictures of bones. Plain x-rays show the bony structures of a joint and are therefore useful for detecting bone damage or other abnormalities. Other imaging tests, such as ultrasound, magnetic resonance imaging (MRI), and computed tomography (CT scan), provide images of the tissues inside and surrounding the joints. They provide more detailed information about the bony structures and also show any abnormalities of the soft tissues such as the joint lining, tendons, and bursa. One or more of these imaging tests may be recommended to detect erosions (bone damage due to arthritis), fractures, calcium deposits, or inflammation in a joint.

For many types of arthritis, changes in the joint are not visible on x-ray for months or even years. However, x-rays are often useful to monitor over time.

WHEN TO SEEK HELP — Some signs and symptoms of arthritis require urgent medical care. If you have one or more swollen joints and any of the following, you should seek medical care as soon as possible.

●Fever

●Weight loss

●An inability to function due to joint pain

●An overall sense of feeling ill

●Sudden weakness of specific muscle groups

ARTHRITIS TREATMENT — The treatment of arthritis depends upon the specific cause (see "Patient education: Osteoarthritis treatment (Beyond the Basics)" and "Patient education: Rheumatoid arthritis treatment (Beyond the Basics)"). Common treatments include physical and occupational therapy, pain relievers (such as acetaminophen), antiinflammatory medications (such as ibuprofen), and medications that suppress the immune system (such as prednisone or methotrexate). Antibiotic treatment is standard for bacterial joint infections.

WHERE TO GET MORE INFORMATION — Your healthcare provider is the best source of information for questions and concerns related to your medical problem.

This article will be updated as needed on our web site (www.uptodate.com/patients). Related topics for patients, as well as selected articles written for healthcare professionals, are also available. Some of the most relevant are listed below.

Patient level information — UpToDate offers two types of patient education materials.

The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.

Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon.

Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based. Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading.

Clinical manifestations and diagnosis of arthritis associated with inflammatory bowel disease and other gastrointestinal diseases
Clinical manifestations of rheumatoid arthritis
Clinical manifestations and diagnosis of psoriatic arthritis
Diagnosis and differential diagnosis of rheumatoid arthritis
Imaging techniques for evaluation of the painful joint
Monoarthritis in adults: Etiology and evaluation
Evaluation of the adult with polyarticular pain
General principles and overview of management of rheumatoid arthritis in adults
Overview of the systemic and nonarticular manifestations of rheumatoid arthritis
Septic arthritis in adults
Treatment of psoriatic arthritis
Clinical manifestations and diagnosis of peripheral spondyloarthritis in adults
Viral arthritis: Causes and approach to evaluation and management

The following organizations also provide reliable health information.

●National Library of Medicine

(www.medlineplus.gov/arthritis.html, available in Spanish)

●National Institute of Arthritis and Musculoskeletal and Skin Diseases

(301) 496-8188

(www.niams.nih.gov/health-topics/arthritis)

●National Institute on Aging

(https://www.nia.nih.gov/health/osteoarthritis, available in Spanish)

●American College of Rheumatology

(404) 633-3777

(www.rheumatology.org/patient-information)

●The Arthritis Foundation

(800) 283-7800

(www.arthritis.org)

Patient Support — There are a number of online forums where patients can find information and support from other people with similar conditions.

Disclaimer: This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider's examination and assessment of a patient's specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms. 2024© UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.

Topic 517 Version 34.0

خرید پکیج

Patient education: Arthritis (Beyond the Basics)