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Arthritis

Arthritis (from Greek arthro-, joint + -itis, inflammation) is a group of conditions that affect the health of the bone joints in the body. One in three adult Americans suffer from some form of arthritis and the disease affects about twice as many women as men. more...

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Arthritic diseases include rheumatoid arthritis and psoriatic arthritis, which are autoimmune diseases; septic arthritis, caused by joint infection; and the more common osteoarthritis, or degenerative joint disease. Arthritis can be caused from strains and injuries caused by repetitive motion, sports, overexertion, and falls. Unlike the autoimmune diseases, osteoarthritis largely affects older people and results from the degeneration of joint cartilage. Other forms are discussed below.

Arthritic joints can be sensitive to weather changes. The increased sensitivity is thought to be caused by the affected joints developing extra nerve endings in an attempt to protect the joint from further damage.

Signs and symptoms

All arthritides feature pain, which is generally worse in the morning and on initiating movement, and resolves in the course of time. In elderly people and children, the pain may not be the main feature, and the patient simply moves less (elderly) or refuse to use the affected limb (children).

When faced with joint pain, a doctor will generally ask about several other medical symptoms (such as fever, skin symptoms, breathlessness, Raynaud's phenomenon) that may narrow down the differential diagnosis to a few items, for which testing can be done.

Arthritis and fever together are pointers towards septic arthritis (see below). This is a medical emergency, and requires urgent referral to a rheumatologist.

Diagnosis

The various types of arthritis can be distinguished by the pace of onset, the age and sex of the patient, the amount of (and which) joints affected, additional symptoms such as psoriasis, iridocyclitis, Raynaud's phenomenon, and rheumatoid nodules, and other clues.

Blood tests and X-rays of the affected joints are often performed to make the diagnosis. X-rays can show erosions or bone appositions.

Screening blood tests: full blood count, electrolytes, renal function, liver enzymes, calcium, phosphate, protein electrophoresis, C-reactive protein and the erythrocyte sedimentation rate (ESR). Specific tests are the rheumatoid factor, antinuclear factor (ANF), extractable nuclear antigen and specific antibodies whenever the ANF is found to be positive.

Treatment

Treatment options vary depending on the precise condition, but include surgery, and drug treatment, reduction of joint stress, physical and occupational therapy, and pain management. There are also numerous herbal remedies that purportedly treat arthritis, including Harpagophytum procumbens. For specifics, see the articles on the individual conditions listed below.

In March 2005, researchers at Harvard Medical School and Brigham and Women's Hospital in the USA found that a diet rich in oily fish raised the body's production of an anti-inflammatory fat, and may thus reduce the effects of arthritis. According to their study published in the Journal of Experimental Medicine, this diet worked best when combined with low aspirin doses.

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Glucosamine: arthritis pain's natural foe just got more street credibility at the American College of Rheumatology's annual scientific meeting
From Better Nutrition, 1/1/06 by Kimberly J. Retzlaff

No matter how active we are, even the fittest person can have a bad day or two, thanks to joints that make moving a knee, hip or shoulder a pain. Luckily, despite some recent conflicting reports, glucosamine researchers keep proving that this shellfish-derived supplement can be useful against arthritis.

During the American College of Rheumatology's annual scientific meeting in November 2005, two major glucosamine studies had people buzzing. First, Spanish researchers called glucosamine "the preferred symptomatic medication" for knee osteoarthritis (OA), based on a trial involving 318 patients who were randomly assigned to take 1,500mg of glucosamine daily, or 3,000mg of acetaminophen daily or just a placebo. After six months, the glucosamine users had significantly less pain in their knees than those taking either the placebo or even acetaminophen.

The other, larger study was done at the University of Utah, Salt Lake City. Researchers there gave one of five therapies--glucosamine, chondroitin, a combination of the two, the arthritis drug celecoxib (Celebrex) or a placebo--to 1,258 patients with knee arthritis. After six months, "We found a highly significant result favoring the combination [of glucosamine and chondroitin]," Daniel O. Clegg, MD, told the gathering of scientists. In addition, people with the most pain got the most relief: 79.2 percent of those in the highest pain group had at least a 20 percent pain reduction from taking the glucosamine/chondroitin combination. By comparison, only 54.3 percent of those taking the placebo reported any improvement in their pain at all.

So, barring any allergies to shellfish, this little wonder from the sea might be just what your knees need.

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