Arthritis

Arthritis means joint inflammation, but the term is used to describe around 200 conditions that affect joints, the tissues that surround the joint, and other connective tissue. It is a rheumatic condition.

Overview

The most common form of arthritis is osteoarthritis. Other common rheumatic conditions related to arthritis include gout, fibromyalgia, and rheumatoid arthritis (RA).

Rheumatic conditions tend to involve pain, aching, stiffness, and swelling in and around one or more joints. The symptoms can develop gradually or suddenly. Certain rheumatic conditions can also involve the immune system and various internal organs of the body. Some forms of arthritis, such as rheumatoid arthritis and lupus (SLE), can affect multiple organs. Arthritis is more common among adults aged 65 years or older, but it can affect people of all ages, including children.

Symptoms

Arthritis:

Joint pain.
Stiffness when you wake up or after you’ve been sitting for a while.
Tenderness - the area is sore when touched.
Lack of movement - the joint won’t complete its full range of motion.
Grating - the patient might feel things rubbing together inside the joint.
Bone spurs - lumps of bone form around the joint.

Rheumatoid Arthritis:

Causes

Cartilage degradation: Cartilage is a firm but flexible connective tissue in a human being’s joints. It protects the joints by absorbing the pressure and shock created when one moves and puts stress on them. A reduction in the normal amount of this cartilage tissue cause arthritis.
Osteoarthritis: Normal wear and tear causes OA, one of the most common forms of arthritis. An infection or injury to the joints can exacerbate this natural breakdown of cartilage tissue. Your risk of developing OA may be higher if you have a family history of the disease.
Rheumatoid Arthritis: Another common form of arthritis, RA, is an autoimmune disorder. It occurs when the body’s immune system attacks the tissues of the body. These attacks affect the synovium, a soft tissue in the joints that produces a fluid that nourishes the cartilage and lubricates the joints. The exact cause of the immune system’s attacks is unknown. But scientists have discovered genetic markers that increase your risk of developing RA fivefold.

Diagnosis

Reviewing the medical history and current symptoms of a patient.
A doctor can perform arthrocentesis (the procedure of removing fluid from a joint) and analyze it for inflammation levels in the blood and joint fluids, which can help determine what kind of arthritis one has. Blood tests that check for specific types of antibodies like anti-CCP (anti-cyclic citrullinated peptide), RF (rheumatoid factor), and ANA (antinuclear antibody) are also common diagnostic tests.
Imaging scans such as X-ray, MRI, and CT scans, produce an image of bones and cartilage. This gives a clear picture and can rule out other causes of symptoms, such as bone spurs.

Treatment

Treatment for arthritis aims to control pain, minimize joint damage, and improve or maintain function and quality of life. A range of medications and lifestyle strategies can help achieve this and protect joints from further damage. Treatment might involve:

Medications.
Non-pharmacologic therapies.
Physical or occupational therapy.
Splints or joint assistive aids.
Patient education and support.
Weight loss.
Surgery, including joint replacement.

Medication

Non-inflammatory types of arthritis, such as osteoarthritis, are often treated with pain-reducing medications, physical activity, weight loss if the person is overweight, and self-management education. Medications will depend on the type of arthritis. Commonly used drugs include:

Analgesics: These reduce pain, but have no effect on inflammation. Examples include acetaminophen (Tylenol), tramadol (Ultram) and narcotics containing oxycodone (Percocet, Oxycontin) or hydrocodone (Vicodin, Lortab). Tylenol is available to purchase online.
Non-steroidal anti-inflammatory drugs (NSAIDs): These reduce both pain and inflammation. NSAIDs include available to purchase over-the-counter or online, including ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve). Some NSAIDs are available as creams, gels or patches which can be applied to specific joints.
Counterirritants: Some creams and ointments contain menthol or capsaicin, the ingredient that makes hot peppers spicy. Rubbing these on the skin over a painful joint can modulate pain signals from the joint and lessen pain. Various creams are available to purchase online.
Disease-modifying antirheumatic drugs (DMARDs): Used to treat RA, DMARDs slow or stop the immune system from attacking the joints. Examples include methotrexate (Trexall) and hydroxychloroquine (Plaquenil).
Biologics: Used with DMARDs, biologic response modifiers are genetically engineered drugs that target various protein molecules involved in the immune response. Examples include etanercept (Enbrel) and infliximab (Remicade).
Corticosteroids: Prednisone and cortisone reduce inflammation and suppress the immune system.

Few of the diseases which can be treated using infusion therapies are :

What is vasculitis?

It is an inflammation of the blood vessels. Blood vessels sometimes stretch, become weak, increase in size or become narrow, and sometimes close. Vasculitis can affect people of all ages but it is more prevalent in certain age groups more often than others. Some types may be mild and some may be severe affecting the internal organs.

What is Behcet's disease?

Behçet disease is a rare vasculitic disorder that is characterized by a triple-symptom complex of recurrent oral aphthous ulcers, genital ulcers, and uveitis.

Symptoms

Behcet’s syndrome or vasculitis can exhibit various symptoms. They include:

Eye – anterior and posterior uveitis resulting in blurry vision, light sensitivity, and redness of the eyes.
Mouth – painful ulcers.
Skin – skin lesions that resemble acne in appearance anywhere on the body.
Lungs – aneurysms that can lead to bleeding.
Joints – arthritis or arthralgias.
Brain – headaches, confusion, strokes, personality changes, meningitis.
Genitals – painful genital lesions.
Gastrointestinal Tract – ulcerations anywhere in the GI tract.

Diagnosis

By looking at the medical history and some physical examination, few diagnostic test and procedures, a doctor could rule out mimic vasculitis from the actual ones. Few of the tests are :

Blood tests - These tests look for signs of inflammation, such as a high level of C-reactive protein. A complete blood cell count can tell whether you have enough red blood cells. Blood tests that look for certain antibodies — such as the anti-neutrophil cytoplasmic antibodies test — can help diagnose vasculitis.
Urine tests - These tests may reveal whether the urine contains red blood cells or has too much protein, which can signal a medical problem.
Imaging tests - Noninvasive imaging techniques can help determine what blood vessels and organs are affected. They can also help the doctor monitor whether the drug is responding. Imaging tests for vasculitis include X-rays, ultrasound, computerized tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET).
X-rays of your blood vessels (angiography) - During this procedure, a flexible catheter, resembling a thin straw, is inserted into a large artery or vein. A special dye (contrast medium) is then injected into the catheter, and X-rays are taken as the dye fills the artery or vein. The outlines of the blood vessels are visible on the resulting X-rays.
Biopsy - This is a surgical procedure in which a small sample of tissue from the affected area of the body is sent for testing of vasculitis.

Additional Tests

ANA (anti-nuclear antibodies).
Complement levels.
ESR.
CRP.
ANCA.

Treatment

The main goal of treating vasculitis is to reduce inflammation in the affected blood vessels. People who have severe vasculitis are treated with prescription medicines. People who have mild vasculitis may find relief with over-the-counter pain medicines, such as acetaminophen, aspirin, ibuprofen or naproxen.

Medication

RITUXAN
SOLUMEDROL

What is rheumatoid athritis ?

Rheumatoid arthritis is a chronic inflammatory disorder that can affect more than just the joints and the condition can sometimes damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels. Rheumatoid arthritis affects the lining of the joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.

Implications

Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of the joints, causing a painful swelling that can eventually result in bone erosion and joint deformity. The inflammation associated with rheumatoid arthritis is what can damage other parts of the body as well. While new types of medications have improved treatment options dramatically, severe rheumatoid arthritis can still cause physical disabilities.

Causes

An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues. It occurs when the system attacks the synovium - the lining of the membrane that surrounds the joints. The resulting inflammation thickens the synovium, which can eventually destroy the cartilage and bone within the joint. The tendons and ligaments that hold the joint together weaken and stretch. Gradually, the joint loses its shape and alignment.