Inflammatory Arthritis: Types, Causes and Diagnosis

What is Inflammatory Arthritis Disease? 

Inflammatory arthritis is a group of diseases characterised by inflammation of the joints and, often, other tissues. These conditions are autoimmune or autoinflammatory diseases, where the body's immune system mistakenly attacks its tissues, causing inflammation and pain.

Types of Inflammatory Arthritis

The most common types of inflammatory arthritis disease include:

Rheumatoid Arthritis (RA) 

This chronic inflammatory disorder typically affects the small joints in the hands and feet. Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of the joints, causing painful swelling that can eventually result in bone erosion and joint deformity. Effective rheumatoid arthritis treatment is crucial for managing this condition.

Psoriatic Arthritis

Often considered a type of viral inflammatory arthritis, this form of arthritis affects some people with psoriasis, which features red patches of skin topped with silvery scales. Psoriatic arthritis can affect joints on one or both sides of the body.

Ankylosing Spondylitis 

This is a type of arthritis that primarily affects the spine, although other joints can become involved. It causes vertebrae inflammation, leading to severe, chronic pain and discomfort.

Gout

Caused by the deposition of uric acid crystals in the joints, gout is characterised by sudden, severe attacks of pain, swelling, redness, and tenderness in the joints, often the joint at the base of the big toe.

Juvenile Idiopathic Arthritis (JIA) 

This is the most common type in children under 16. It causes pain, swelling, stiffness, and loss of motion in the joints. Early diagnosis and appropriate management are crucial for preventing long-term complications and supporting an affected child's well-being.

Systemic Lupus Erythematosus (SLE)

Lupus can cause inflammation in many body systems, including the joints, skin, kidneys, blood cells, brain, heart, and lungs. The symptoms can vary widely, and treatment aims to manage flare-ups and improve the patient's quality of life through a multidisciplinary approach involving medications and lifestyle adjustments.

Signs and Symptoms of Inflammatory Arthritis

The signs and symptoms of inflammatory arthritis can vary depending on the specific type of arthritis, but there are several common symptoms that many people with these conditions may experience. These include:

• Joint pain and stiffness: One of the hallmark symptoms of inflammatory arthritis is pain, which can be persistent or intermittent. 
• Swelling and redness: The affected joints may swell and sometimes become red and warm to the touch, indicating inflammation.
• Decreased range of motion: Inflammation and pain can limit the movement of the affected joints, leading to difficulty in performing daily activities.
• Fatigue: Many people with inflammatory arthritis experience a general feeling of tiredness and lack of energy.
• Fever and malaise: In some cases, especially during flare-ups, individuals might experience low-grade fever and a feeling of general unwellness.
• Deformity: Chronic inflammation can lead to joint deformity over time, particularly in conditions like rheumatoid arthritis.

Symmetrical symptoms: Particularly in rheumatoid arthritis, symptoms often appear symmetrically, meaning both sides of the body are affected similarly.

Causes of Inflammatory Arthritis

The causes of inflammatory arthritis are complex and often involve a combination of genetic, environmental, and immunological factors. Here's a breakdown of the key factors contributing to the development of various types of inflammatory arthritis:

• Genetic predisposition: Inherited genes increase susceptibility to inflammatory arthritis, but don't guarantee development.
• Autoimmune response: The body's immune system mistakenly attacks its joint tissues, causing inflammation and arthritis.
• Environmental triggers: Factors like infections, smoking, or exposure to certain substances can initiate or worsen arthritis in genetically susceptible individuals.
• Chronic inflammation: Persistent inflammation in the body, due to various causes, leads to joint damage and arthritis symptoms.
• Hormonal factors: Hormonal imbalances or changes can influence the onset and progression of inflammatory arthritis, especially in women.
• Dysfunction of the immune system: Abnormal immune system activity leads to inflammation and joint damage in arthritis.

Diagnosing Inflammatory Arthritis 

After thoroughly examining the patient's medical history and a joint-focused physical assessment, the healthcare provider may recommend additional diagnostic procedures. Typically, these include a combination of blood tests and imaging studies.

Blood tests are instrumental in identifying inflammatory arthritis and may involve:

• Complete blood count (CBC): Evaluating the levels of various blood cells.
• Rheumatoid factor (RF): Often indicative of Rheumatoid Arthritis (RA).
• C-reactive protein and erythrocyte sedimentation rate: Providing insights into inflammation.
• Uric acid test: Assessing elevated uric acid levels, potentially signalling gout.
• Genetic tests: Identifying genetic markers associated with specific arthritis types, such as axial spondyloarthritis and Juvenile Idiopathic Arthritis (JIA).

In addition to blood tests, imaging studies offer visual information on affected joints, helping detect signs of inflammation and damage. Common imaging technologies for diagnosing inflammatory arthritis encompass:

• Magnetic Resonance Imaging (MRI)
• Computed Tomography (CT) Scan
• X-ray
• Ultrasound

Collectively, these diagnostic measures contribute to a comprehensive understanding of the patient's condition, facilitating the healthcare provider's ability to formulate an accurate diagnosis and personalised treatment plan.

Inflammatory Arthritis Treatment 

The treatment of inflammatory arthritis aims to reduce symptoms, prevent joint damage, and maintain quality of life. Here are the key approaches:

Medications 

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Reduce pain and inflammation.
• Corticosteroids: Quickly control inflammation; used for flare-ups.
• Disease-Modifying Antirheumatic Drugs (DMARDs): Slow disease progression and prevent joint/tissue damage; include methotrexate, sulfasalazine, etc.
• Biologic agents: Target specific parts of the immune system; used for cases not responding to traditional DMARDs.
• Janus Kinase (JAK) inhibitors: A newer drug class that blocks certain immune responses.

Physical Therapy 

It helps maintain joint function and range of motion and reduces pain.

Occupational Therapy 

Teaches ways to perform daily activities without putting extra stress on painful joints.

Surgery

In severe cases, surgical options like joint replacement may be considered to repair or replace damaged joints.

Lifestyle Modifications 

• Exercise: Low-impact activities help maintain joint flexibility and muscle strength.
• Weight management: Reducing weight stress on joints, particularly the knees, hips, and spine.
• Diet: Some people find symptom relief with dietary changes, though this varies individually.
• Smoking cessation: Smoking can exacerbate symptoms and disease progression.

Alternative Therapies

Some patients find relief with acupuncture, massage, or other complementary therapies, though these should not replace conventional treatment.

Conclusion

Inflammatory arthritis encompasses a range of conditions described by joint inflammation, with diverse types and causes that require accurate diagnosis for effective management. Understanding the different forms, such as rheumatoid arthritis and psoriatic arthritis, is crucial for early diagnosis. Max Healthcare offers rheumatoid arthritis treatment and arthritis treatment with a team of dedicated professionals, including physiotherapists and rheumatologists.