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Arthritis and Rheumatism

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Arthritis and Rheumatism

Osteoarthritis, the commonest of these conditions, is basically “wear  and tear” of the joints. The joint  becomes stiff and painful, and may creak as it is moved.As the cartilage wears down, the bones on either side of the joint  may react by forming small bony outgrowths called osteophytes. One of  the sites where bony nodes can easily be seen is the last joint of the  fingers. Spondylosis is a similar problem affecting the spine; here the  main problem is degeneration of the disks which separate the vertebrae.

As one would expect with a degenerative condition the prevalence of osteoarthritis increases with age, it affects  around 70 per cent of the over-60s. It is the commonest  of all rheumatological conditions, and indeed probably the commonest of  all chronic diseases, because many sufferers live with it for many  years. Not surprisingly it tends to affect weight-bearing joints (eg low  back, hips and knees). Joint injuries or overuse (for instance heavy  physical work or professional sport) predispose to osteoarthritis later  in life. Overweight is another important factor.

The other two main groups of arthritis and rheumatism are  inflammatory arthritis, of which the commonest form is rheumatoid  arthritis, and soft tissue rheumatism. Rheumatoid arthritis affects  about one person in a hundred; it is nearly three times commoner in  women than men (for unknown reasons). Its cause, too, remains  frustratingly elusive. It tends to come on at an earlier age than  osteoarthritis (typically in the 30s to 50s) and is more aggressive,  running a more rapid course: about a third of sufferers are seriously  disabled within ten years, although it is very variable. It particularly  affects the small joints, especially of the hands and feet, causing a  typical hand deformity where the fingers slant sideways. But it can  affect almost any joint in the body, and also cause nodules under the  skin and eye problems. There are many other forms of inflammatory  arthritis, some of them associated with infections.

The final group is true rheumatism, affecting the soft connective  tissues rather then the joints themselves. There are many forms. They include tennis elbow, affecting the outer side of the elbow, and golfer’s  elbow, which affects the inner side. Capsulitis – inflammation of the  capsule of tissues that surround the joint – most commonly affects the  shoulder, and may lead to a stiff “frozen” shoulder.

Some of the more  amusing names are reserved for bursitis – inflammation of the bursae ,  cushioning pads which overlie many joints. These include Housemaid’s  Knee (also known as Clergyman’s Knee),  from too much kneeling. 

The most common form of soft tissue rheumatism, however, is  fibromyalgia (which used to be known as fibrositis). It is commoner in women than men. It is a  controversial condition; some believe that fibromyalgia and chronic  fatigue syndrome (ME) are varieties of the same condition, certainly  there are similarities. The typical features are widespread  musculoskeletal pain and aching with tender points at several specific locations. It is frequently associated with poor sleep and fatigue as  well as other problems including migraine and irritable bowel syndrome.

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