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ARTHRITIS

An umbrella term describing painful conditions in which there is damage to the joints. Most common are osteoarthritis (OA) and rheumatoid arthritis (RA); others are psoriatic arthritis, septic arthritis, gouty arthritis (also known as crystal-induced arthritis or more commonly, gout) and ankylosing spondylitis (affecting the spine). Around 10 million people in the UK have arthritis.

Osteoarthritis

Important cause of impaired mobility in older people (uncommon before age 45). A non-inflammatory condition in which components of affected joints (not only cartilage, also bone, muscle, synovium, capsule) gradually degenerate, often resulting in severe pain, joint swelling and misalignment. Joints commonly affected are hands, spine, knees and hips. Exacerbations last weeks to months.

NICE CG177  Osteoarthritis: care and management of OA in adults, 2014 (updated 2020). https://www.nice.org.uk/guidance/cg177

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The challenge of managing osteoarthritis in primary care Sarah Ryan 

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Rheumatoid arthritis

An inflammatory arthritis; damage to (predominantly) peripheral joints progresses to destruction and deformity. Usually starts symmetrically in small joints, especially of hands, and most common in middle age. Possible acute inflammatory arthritis needs urgent recognition and immediate specialist referral because early treatment with disease-modifying anti-rheumatic drugs (DMARDS) can improve outcome.

Signs and symptoms of acute inflammatory arthritis are:

  • Persistent swelling in more than one joint
  • Early morning stiffness lasting more than 30 minutes
  • Involvement of the small joints of hands and feet

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Rheumatoid arthritis: diagnosis and management Sarah Ryan 

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 Inflammatory arthritis

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