Sunday, May 15, 2022

Arthritis: Essential Terminology

 Being a medical writer, my primary focus is the language of medicine, which is the starting point for understanding the concepts and engaging the health care system, when necessary. I'll define these terms involving arthritis in the larger context of other diseases.

Arthritis - Inflammation of one or more joints. This is experienced by (Latin): pain (dolor), warmth (calor), redness (rubor) and swelling (tumor), the clinical symptoms of inflammation as they were defined in the first century AD by the Roman scholar Celsus. You could also include decreased function, as anyone with a sprained ankle can testify to as they used rest, ice, compression and elevation (RICE) to help with recovery. People with arthritis also report stiffness as a symptom.

Because joint inflammation is such a non-specific term, arthritis encompasses more than 100 conditions that affect the joints.

According to the CDC, the main types of arthritis are:

Osteoarthritis (OA) - This is the "wear and tear" condition involving damaged or worn down cartilage that prevents bone-on-bone abrasion with the normal working of the joint. It typically affects the hands, hips and knees, with age as a predisposing factor.

Rheumatoid Arthritis (RA) - Rheumatism, an ancient Greek word coined before the underlying process was known, relates to auto-immune disease, which means your body's mistakenly senses your normal tissue as foreign and begins an attack. There are various ways this can be started. In rheumatic fever, heart tissue can be damaged, sometimes resulting in deformed valves, when strep throat or scarlet fever is not adequately treated. The cause is infection with the Group A Streptococcus bacterium, which is important to diagnose early.

or Gouty Arthritis is another disease first observed long before the mechanism was known. It was known as the disease of kings because it was believed to be associated with wealth which allowed an excessive diet of meat, seafood and alcohol, to the point where the painful toe wrapped in a bandage was a status symbol.

Gout is caused by the deposition of urate crystals, usually painfully noted in the base of the big toe. It may also cause tophi (chalky nodules), kidney stones, or kidney damage.

Fibromyalgia "is a condition that causes pain all over the body (also referred to as widespread pain), sleep problems, fatigue, and often emotional and mental distress," according to the CDC. It "affects about 4 million US adults, about 2% of the adult population. The cause of fibromyalgia is not known, but it can be effectively treated and managed."

Childhood Arthritis - Also called Juvenile Arthritis, the most common form is Juvenile Idiopathic Arthritis or Juvenile Rheumatoid Arthritis. The term idiopathic is used when the exact cause of the disease is not known, but cases are managed by Pediatric Rheumatologists. There are treatments, but in some cases there will be a long-term remission.

Psoriatic Arthritis - This is associated with Psoriasis, "a skin disease that causes red, itchy scaly patches, most commonly on the knees, elbows, trunk and scalp." It can also cause thick, pitted fingernails. "Psoriatic arthritis is similar to rheumatoid arthritis (RA) in symptoms and joint swelling (inflammation). But it tends to affect fewer joints than RA," reports John Hopkins Medicine.

This post will serve as a primer for the most important terms, but in future posts I'll go more in depth about diagnoses and treatment options.

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