Joint diseases

Joint diseases

Overview

Bones and joints are critical in providing the body with physical capabilities such as a wide variety of motions. There is a lot of overlap between their ailments since the joints are made up of two bones coming together, or articulating. Neglecting them might result in persistent aches and probable impairment.

What is Joint disease?

Joint disease

Any of the diseases or injuries that affect human joints are referred to as joint disease. Arthritis is without a doubt the most well-known joint illness, but there are many more. Joint diseases can be acute or chronic, agonizingly painful or just irritating and unpleasant; they can be isolated to a single joint or affect multiple areas of the skeleton. For the purposes of this article, two major groups are distinguished: joint disorders in which inflammation is the primary set of signs or symptoms, and joint diseases in which inflammation may be present to some extent (as after an injury) but is not the primary characteristic.

Common Joint Disorders includes:

Osteoarthritis

Osteoarthritis

Osteoarthritis is a common illness that affects all individuals to varying degrees by the time they reach middle age. The word osteoarthritis is misleading since the suffix indicates that the ailment is inherently inflammatory. As a result, it is usually referred to as degenerative joint disease, osteoarthrosis, or arthrosis deformans. Spondylosis is the word used when the spine is implicated. Osteoarthritis, unlike rheumatoid arthritis, is not a systemic disease and seldom results in debilitating abnormalities.

In most cases, the lesser anatomical alterations are not accompanied by noticeable symptoms. The alterations are characterized by abrasive wear away of the articular cartilage and deformation of neighboring bone ends. As a result, masses of freshly formed bone (osteophytes) protrude from the joint borders.

The clinical signs of osteoarthritis differ depending on where the lesions are located and how severe they are. Hip osteoarthritis, like that of other joints, is categorized as either primary or secondary. Secondary osteoarthritis develops as a result of an underlying structural or postural abnormality of the joint. However, in around half of the cases, even a thorough investigation fails to reveal such an abnormality; in these circumstances, the osteoarthritis is referred to as primary.

Congenital dysplasia is most likely the most common cause of hip osteoarthritis (dislocation or subluxation of the hip). This word refers to a misalignment of the femoral head, the long bone of the thigh, with its pelvic socket, the acetabulum. There is evidence that many instances occur in infancy as a result of swaddling newborns or carrying them in headboards, both of which keep the thighs stretched. The hip joint is frequently not fully formed before the kid is ready to walk, and this extension forces the head of the femur out of its usual position.

Hip osteoarthritis that occurs in relatively young people (in their 30s or 40s) commonly progresses and necessitates surgical treatment. Two surgical techniques are used: one, an osteotomy, involves bending the upper end of the femur so that the load borne by the joint is distributed more efficiently; the other, amputation of the damaged tissue and replacement with an artificial joint.

Aside from the fast-growing varieties, osteoarthritis of the hips is also common among the elderly. Aging also has a role in the development of various types of degenerative joint disease, since lesions become more frequent and worse over time.

Considerations like these have led to the conclusion that the primary causal elements in degenerative arthritis are improper mechanical loading and senescent joint tissue degeneration. Single injuries, unless they permanently distort a joint, seldom result in osteoarthritis. Repetitive microtrauma (little injuries), on the other hand, such as that caused by powerful pneumatic drill vibrations or certain sporting activities, is more prone to do so. Heavy weight lifting has been linked to spinal involvement in several studies.

The first metatarsophalangeal (MTP) joint, which is placed between the big toe and the remainder of the foot, is a frequent location of osteoarthritis. The development of osteoarthritis of the first MTP joint has been linked to the use of high-heeled shoes and recurrent microtrauma. Osteoarthritis can also be caused by congenital joint deformities and hormone imbalances.

Aside from hip and occasionally knee surgery, treatment includes rest and correct exercise, accident prevention, analgesics, NSAIDs, and corticosteroids to reduce pain, and various forms of physical therapy. Painful osteoarthritis of the first MTP joint can be treated surgically with the installation of a synthetic cartilage implant, which can help keep the big toe mobile.

Rheumatoid arthritis

Rheumatoid arthritis

No causal agent has been identified in certain kinds of arthritis that mimic infectious joint disease. Rheumatoid arthritis is the most common of them. This condition can emerge at any age, although it is more common in the fourth and fifth decades. Juvenile rheumatoid arthritis is a kind that affects youngsters. The same joints on both sides of the body are usually affected by rheumatoid arthritis. Almost every moveable joint can be affected, but fingers, wrists, and knees are most vulnerable. When the afflicted individual awakens, the joints are extremely stiff.

Rheumatoid arthritis is more than just a joint disease; weariness and anemia imply a more widespread systemic involvement. A mild temperature is occasionally seen. Lesions can also arise outside of the joints. The condition is characterized by the involvement of bursas, tendons, and tendon sheaths. One out of every five people affected develops nodules in the subcutaneous tissue near the elbow or elsewhere. Inflammatory alterations can also be detected in tiny arteries and the pericardium, the membrane that surrounds the heart.

The disease's history varies widely from person to person and is distinguished by a conspicuous proclivity for spontaneous remission and aggravation. Joint cartilage is destroyed as a result of ongoing joint inflammation. The extent of articular (joint) disability in rheumatoid arthritis is largely determined by the amount of cartilage damage. If the damage is severe enough, substantial regions of bone may be stripped of cartilage, resulting in adhesions between the articular surfaces. The subsequent development of these adhesions into mature fibrous or bony connective tissue results in a solid union between the bony surfaces (ankylosis), which interferes with joint mobility and may make the joint completely immobile.

In other cases, cartilage and bone loss, combined with weakening of tendons, ligaments, and other supporting structures, results in joint instability and partial dislocation. In a tiny percentage of patients, the illness progresses swiftly, with unrelenting joint deterioration and indications of diffuse vasculitis (inflammation of blood vessels). Rest, analgesic drugs, and therapeutic activities help many patients over the course of many months. In almost one-third of cases, the condition worsens and produces major disability. Without proper physical therapy, the joints can become severely deformed and ankylosed.

There is now compelling evidence that immunologic responses play a significant role in the development of rheumatoid arthritis. Rheumatoid factor, an immunoglobulin that acts as an antibody and reacts with another class of immunoglobulin, is found in the blood of approximately 80 to 90 % of people with rheumatoid arthritis. This immunoglobulin is generated by plasma cells found in areas of tissue damage. There is evidence that this agent might be one or more viruses or viral antigens that live in joint tissues.

Although there is no cure, corticosteroid medicines and nonsteroidal anti-inflammatory drugs (NSAIDs) may aid with pain and inflammation relief. Corticosteroids' efficacy often declines over time, and there are significant drawbacks to their usage, such as increased susceptibility to infection and peptic ulcers. Corticosteroid injection directly into joint tissues may aggravate joint degeneration in certain people.

Disease-modifying antirheumatic medications (DMARDs) may decrease disease progression by preventing additional joint damage. Surgery is frequently beneficial in repairing existing abnormalities. In certain circumstances, a moderate dry climate appears to be advantageous, but the improvement is often insufficient to justify a transfer that would disturb the affected person's life.

At times, there is a close relationship between rheumatoid arthritis and seemingly unrelated illnesses. Rheumatoid arthritis is present in around one-third of Sjögren syndrome patients, and significant levels of rheumatoid factors are generally detected in the circulation. Rheumatoid arthritis coexists with spleen enlargement and a decrease in the quantity of circulating blood cells, particularly white blood cells, in Felty syndrome. The spleen is removed, which returns the quantity of blood cells to normal but has little impact on the arthritis.

Several additional kinds of polyarthritis are similar to rheumatoid arthritis but lack the inflammatory components in the circulation. Psoriatic arthritis, which is connected with the skin illness psoriasis, varies from rheumatoid arthritis in that it prefers the outer rather than the interior joints of the fingers and toes, and it causes greater bone loss. Chronic intestinal illnesses, such as ulcerative colitis, regional enteritis, inflammatory bowel disease, cirrhosis, and Whipple disease, are linked to another kind of arthritis.

Ankylosing spondylitis affects several peripheral joints, such as the hip, however it is more commonly found in the spine and sacroiliac joints. Small synovial joints and intervertebral disk borders are both implicated in the spine. The spine becomes stiff when these structures are bridged by bone. Ankylosing spondylitis affects males eight times more than women. The onset age is younger than that of rheumatoid arthritis. The two conditions are treated similarly, however phenylbutazone is more successful in ankylosing spondylitis than in rheumatoid arthritis.

Gout

Gout

Gout is a painful ailment that commonly affects a toe or another joint in the foot or ankle. It most usually happens in middle age in males; it occurs later in life in women.

Symptoms

Sudden swelling and pain of a joint;
This often occurs during the night

Cause

Gout is caused by blood levels of uric acid that are too high
Seafood, meat, organ-meats (liver for example), and alcoholic beverages can start an attack
The use of some diuretics (“water pills”) can also be associated with attacks

Prevention

Avoiding foods known to worsen gout
Medications prescribed by your healthcare provider can help prevent gout attacks

Bursitis

Bursitis

Bursitis is the swelling and irritation of a bursa, which is a fluid-filled sac that acts as a cushion between muscles, tendons, and joints.

Symptoms

Pain and tenderness when you press around the joint
Stiffness and aching when you move the affected joint
Swelling, warmth, or redness over the joint

Cause

Overuse or change in activity level
Trauma, rheumatoid arthritis, gout, or infection
Sometimes the cause cannot be found

Prevention

Avoid activities that include repetitive movements

Infectious arthritis

Infectious arthritis

Many different forms of microorganisms (bacteria, fungus, viruses) and animal parasites can infect joints. There are three ways to become infected: by direct contamination, through the bloodstream, and through extension from surrounding bone illnesses (osteomyelitis). Direct contamination is mainly caused by penetrating wounds; however, it can also happen during joint surgery.

Infections from the blood can enter the joints via the synovial blood vessels. However, most osteomyelitis foci appear initially in the long bones towards the end of the shaft or near the joint. The infection then spreads into the joint via natural apertures or pathological breaks in the bone's outer layer, or cortex. Hematogenous (blood-borne) infectious arthritis primarily affects women.

One joint (monarthritis) or
A very few joints (oligoarthritis) rather than
Many of them (polyarthritis) and usually affects large joints (knee and hip) rather than small ones.

Joint infections, like infections elsewhere in the body, can induce fever and other systemic signs of inflammation. Pus development in infections caused by bacteria such as staphylococci, hemolytic streptococci, and pneumococci can cause fast destruction to joint cartilage. Tuberculosis of the joint can cause significant bone loss and open routes to the skin. The most prevalent type of this illness is tuberculous spondylitis, often known as Pott disease. It primarily affects young children.

Streptomycin and antituberculous drugs such as isoniazid and rifampin are used to treat the infection. Coccidioides immitis, an organism native to the arid areas of the southwestern United States, causes a common fungal illness in the United States. As with TB, seeding from the lung to the bone generally occurs before joint involvement.

Infectious arthritis exacerbates the symptoms of several sexually transmitted diseases, including gonorrhea. Early therapy with penicillin may give a quick cure and prevent the joint from deteriorating further. Reactive arthritis (Reiter disease), which can arise following food poisoning or infection with certain sexually transmitted infections, normally resolves on its own after many months. Reactive arthritis is distinguished by inflammation of the joints, the urethra, and the conjunctiva of the eyes. Except in the most severe stages of the illness and in congenital syphilis, syphilis does not appear to directly infect the joints.

The latter commonly causes damaging inflammation in newborn infants' developing cartilaginous endings of bones. Untreated, it causes deformity and growth limitation in the affected portion, although early treatment with penicillin may result in total recovery.

Lesions resembling tertiary syphilis can develop in the joints of children with congenital syphilis. Yaws, a nonvenereal illness caused by a closely related bacterium to that which causes syphilis, causes skeletal lesions comparable to syphilis. The disease has been nearly eliminated, although it still affects people in tropical locations.

Traumatic joint diseases

Traumatic joint diseases

Sharp joint injuries range in severity from moderate sprains to overt fractures and dislocations. A sprain is injury to a ligament, tendon, or muscle caused by a rapid twist and transient incomplete dislocation (subluxation) of a joint. There is some little bleeding into these tissues, and recovery normally takes many days. Violent pressures may induce ligament and tendon tears.

Due to the strength of the ligaments and tendons, they are typically pulled from their bone attachments rather than split into pieces. Fibrous union can mend ligamentous, tendinous, and capsular wounds as long as the margins are not completely separated from one other. Internal derangements of the knee most typically occur from rips in the semilunar cartilages (menisci). Typically, the medial meniscus is injured. These rips are more common in athletes and occur when the knee is rotated while the foot stays stationary on the ground.

Locking of the knee is a common sign. Because semilunar cartilages are not repairable, they must be surgically removed. Injuries can also cause hemarthrosis, or bleeding into the joint.

Most traumatic dislocations are treated by immobilization for an extended period of time to allow the capsular and other rips to heal. Surgical repairs are sometimes necessary. Bone fractures around joints may or may not expand into the joint space. Whether they do or do not, the joint's native shape must be restored or arthritic problems are inevitable.

Tumors of joints

Tumors of joints

Joint tumors are rare. Numerous cartilaginous nodules grow in the soft tissues of the joint in synovial chondromatosis, a benign disorder. The lesion is generally limited to one joint, most commonly the knee, and affects young or middle-aged individuals. It can cause discomfort or swelling and is generally treated by removing a part of the synovial membrane. The tumor is seldom cancerous.

When cartilaginous nodules contain islands of bone, the condition is referred to as synovial osteochondromatosis. Synovial osteochondromatosis, like synovial chondromatosis, is frequently a spontaneous or primary condition with no recognized etiology. However, in many cases, it develops as a result of other synovial disorders, such as rheumatoid arthritis and even osteoarthritis.

Synoviomas, also known as synovial sarcomas, are malignant tumors that develop in the tissues surrounding joints—the capsule, tendon sheaths, bursae, fasciae, and intermuscular septa, or divisions—and very rarely within the joint itself. Although they can occur at any age, teens and young adults are the most likely to experience them. Legs are more frequently involved than arms.

Tumors spread locally as well as to regional lymph nodes and the lungs. Synoviomas are not highly X-ray sensitive, and medication therapy has been ineffectual. If distant spread has not happened at the time the problem is detected, the recommended therapy is drastic excision, which may entail amputation of the affected region.

Conclusion

Joint diseases

Bones and joints allow individuals to move and go about their everyday lives, thus maintaining their health is critical. Some of the most common bone and joint illnesses are preventable or treatable with a healthy lifestyle and early identification.