Arthritis patients at risk

Arthritis is common to those patients having musculoskeletal disorders. It is not a disease condition rather a disease manifestation.

Rheumatoid Arthritis

The etiology of rheumatoid arthritis is unknown. Investigation as to causation is being explored primarily in relation to autoimmune, infectious, hereditary, environmental, and psychosomatic factors.

• Autoimmune Factors- Impressive evidence supports the importance of an immunologic mechanism in the pathogenesis of rheumatoid arthritis. Evidence to support this theory was the discovery of the rheumatoid factor (RF) in the serum of patients with rheumatoid arthritis. This factor has an affinity for denatured gamma globulin probably in the patient’s synovial membrane. It was this discovery that led to the classification of rheumatoid arthritis as an autoimmune disease.

• Infectious Factors- The inflammatory nature of rheumatoid arthritis implied an infectious process. However, overwhelming negative results of bacteriologic studies suggest that rheumatoid arthritis is probably not due to a bacterium. The focus is on viruses because there are several viral infections that produce transient arthritis even though no virus has been found in the synovium.

•  Hereditary Factors – It was noted by clinician that rheumatoid arthritis seemed to occur most often within the same families, raising the question of heredity as a contributing factor. Several studies of twins support the possibility that rheumatoid arthritis occurs twice as often in people who are blood relatives and therefore are genetically predispose to this disease. Theses statistics suggest a hereditary influence, but no clear-cut genetic pattern has been identified.

• Environmental Factors – Other researchers favor an environmentally based theory because of the following findings: (1) The onset for a large number of people has occurred in the spring of the year, and (2) many people have increased symptomatology when the humidity increases and the barometric pressure decreases.

• Psychosomatic Factors- The literature abounds with research relating to the personalities and psychological mechanisms of patients with rheumatoid arthritis. There is little support for the theory that certain “personality types” relate to the cause of this disease, but the course of rheumatoid arthritis appears to be influenced by emotional factors.

Bacterial Arthritis

Factors that predispose to such infections are a high degree of susceptibility on the part of the patient, recent joint surgery or trauma, intraarticular injections, and rheumatoid arthritis.

Osteoarthritis

Women are more severely affected by the disease, although the incidence rates are the same for males and females. Primary joint disease is the most common type of noninflammatory joint disease. The etiology is unknown, but age is an important factor in the development of the disease. The quantity and quality of proteoglycans decrease with the aging process and predispose the cartilage to break down and degenerate. Research indicates there may be a genetic component to the development of osteoarthritis.

Gouty Arthritis (gout)

Gout is more common to men than women. Ninety- five percent of the cases of gout occur in men between the ages 20 and 60. There is also a hereditary predisposition for gout. Many have heard the old wives’ tale that much indulgence in rich foods and alcohol will precipitate an attack of gout. In fact, the patient should be instructed to avoid foods with high purine content, like liver, kidneys, sweetbreads, anchovies, and meat gravies.