Diagnosis is made by clinical examination from an appropriate health professional, and may be supported by other tests such as radiology and blood tests, depending on the type of suspected<unk> . All<unk> es potentially feature pain. Pain patterns may differ depending on the<unk> es and the location. Rheumatoid<unk>  is generally worse in the morning and associated with stiffness lasting over 30 minutes. However, in the early stages, patients may have no symptoms after a warm shower. Osteoarthritis, on the other hand, tends to be associated with morning stiffness which eases relatively quickly with movement and exercise. In the aged and children, pain might not be the main presenting feature; the aged patient simply moves less, the infantile patient refuses to use the affected limb. Osteoarthritis in the left hand index finger of a 63 year-old woman. Elements of the history of the disorder guide diagnosis. Important features are speed and time of onset, pattern of joint involvement, symmetry of symptoms, early morning stiffness, tenderness, gelling or locking with inactivity, aggravating and relieving factors, and other systemic symptoms. Physical examination may confirm the diagnosis or may indicate systemic disease. Radiographs are often used to follow progression or help assess severity. Blood tests and X-rays of the affected joints often are performed to make the diagnosis. Screening blood tests are indicated if certain<unk> es are suspected. These might include: rheumatoid factor, antinuclear factor (ANF), extractable nuclear antigen, and specific antibodies. Osteoarthritis Osteoarthritis is the most common form of<unk> . It affects humans and other animals, notably dogs, but also occurs in cats and horses. It can affect both the larger and the smaller joints of the body. In humans, this includes the hands, wrists, feet, back, hip, and knee. In dogs, this includes the elbow, hip, stifle (knee), shoulder, and back. The disease is essentially one acquired from daily wear and tear of the joint; however, osteoarthritis can also occur as a result of injury. Osteoarthritis begins in the cartilage and eventually causes the two opposing bones to erode into each other. The condition starts with minor pain during physical activity, but soon the pain can be continuous and even occur while in a state of rest. The pain can be debilitating and prevent one from doing some activities. In dogs, this pain can significantly affect quality of life and may include difficulty going up and down stairs, struggling to get up after lying down, trouble walking on slick floors, being unable to hop in and out of vehicles, difficulty jumping on and off furniture, and behavioral changes (e.g., aggression, difficulty squatting to toilet). Osteoarthritis typically affects the weight-bearing joints, such as the back, knee and hip. Unlike rheumatoid<unk> , osteoarthritis is most commonly a disease of the elderly. The strongest predictor of osteoarthritis is increased age, likely due to the declining ability of chondrocytes to maintain the structural integrity of cartilage. More than 30 percent of women have some degree of osteoarthritis by age 65. Other risk factors for osteoarthritis include prior joint trauma, obesity, and a sedentary lifestyle. Rheumatoid<unk>  Bone erosions by rheumatoid<unk> . Rheumatoid<unk>  (RA) is a disorder in which the body's own immune system starts to attack body tissues. The attack is not only directed at the joint but to many other parts of the body. In rheumatoid<unk> , most damage occurs to the joint lining and cartilage which eventually results in erosion of two opposing bones. RA often affects joints in the fingers, wrists, knees and elbows, is symmetrical (appears on both sides of the body), and can lead to severe deformity in a few years if not treated. RA occurs mostly in people aged 20 and above. In children, the disorder can present with a skin rash, fever, pain, disability, and limitations in daily activities. With earlier diagnosis and aggressive treatment, many individuals can lead a better quality of life than if going undiagnosed for long after RA's onset. The risk factors with the strongest association for developing rheumatoid<unk>  are the female sex, a family history of rheumatoid<unk> , age, obesity, previous joint damage from an injury, and exposure to tobacco smoke. Bone erosion is a central feature of rheumatoid<unk> . Bone continuously undergoes remodeling by actions of bone resorbing osteoclasts and bone forming osteoblasts. One of the main triggers of bone erosion in the joints in rheumatoid<unk>  is inflammation of the synovium, caused in part by the production of pro-inflammatory cytokines and receptor activator of nuclear factor kappa B ligand (RANKL), a cell surface protein present in Th17 cells and osteoblasts. Osteoclast activity can be directly induced by osteoblasts through the RANK/RANKL mechanism. Lupus Lupus is a common collagen vascular disorder that can be present with severe<unk> . Other features of lupus include a skin rash, extreme photosensitivity, hair loss, kidney problems, lung fibrosis and constant joint pain. Gout Gout is caused by deposition of uric acid crystals in the joints, causing inflammation. There is also an uncommon form of gouty<unk>  caused by the formation of rhomboid crystals of calcium pyrophosphate known as pseudogout. In the early stages, the gouty<unk>  usually occurs in one joint, but with time, it can occur in many joints and be quite crippling. The joints in gout can often become swollen and lose function. Gouty<unk>  can become particularly painful and potentially debilitating when gout cannot successfully be treated. When uric acid levels and gout symptoms cannot be controlled with standard gout medicines that decrease the production of uric acid (e.g., allopurinol) or increase uric acid elimination from the body through the kidneys (e.g., probenecid), this can be referred to as refractory chronic gout. Comparison of types + Comparison of some major forms of<unk>  Osteoarthritis Rheumatoid<unk>  Gouty<unk>  Speed of onset Months Weeks-months Hours for an attack Main locations Weight-bearing joints (such as knees, hips, vertebral column) and hands Hands (proximal interphalangeal and metacarpophalangeal joint) wrists, ankles, knees and hips Great toe, ankles, knees and elbows Inflammation May occur, though often mild compared to inflammation in rheumatoid<unk>  Yes Yes Radiologic changes * Narrowed joint space * Osteophytes * Local osteosclerosis * Subchondral cysts * Narrowed joint space * Bone erosions * "Punched out" bone erosions Laboratory findings None Anemia, elevated ESR and C-reactive protein (CRP), rheumatoid factor, anti-citrullinated protein antibody Crystal in joints Other features * No systemic signs * Bouchard's and Heberden's nodes * Extra-articular features are common * Ulnar deviation, swan neck- and Boutonniere deformity of the hand * Tophi * Nephrolithiasis Other Infectious<unk>  is another severe form of<unk> . It presents with sudden onset of chills, fever and joint pain. The condition is caused by bacteria elsewhere in the body. Infectious<unk>  must be rapidly diagnosed and treated promptly to prevent irreversible joint damage. Psoriasis can develop into psoriatic<unk> . With psoriatic<unk> , most individuals develop the skin problem first and then the<unk> . The typical features are continuous joint pains, stiffness and swelling. The disease does recur with periods of remission but there is no cure for the disorder. A small percentage develop a severely painful and destructive form of<unk>  which destroys the small joints in the hands and can lead to permanent disability and loss of hand function.
Arthritis
Myofascial pain syndrome
Arthralgia
Polyarthritis
Monoarthritis
Arthropathy
Dermatitis
Osteopathy