Arthritis book-a-consultationis an inflammatory condition of any joint. It is characterised by the presence of swelling and pain over the joint. It usually affects elderly although Rheumatoid arthritis can affect younger individuals. Although there are more than 100 varieties, the three most common forms are osteoarthritis, rheumatoid arthritis and gout. Another common cause in developing countries is Post traumatic arthritis following major knee fractures. The last condition is more common in young patients.

Pain over a joint which may be intermittent or constant Swelling over the. Sometimes more than one joint may be involved. Early morning stiffness, which takes a while to disappear. In osteo-arthritis this may become better with use of the joint but in others like rheumatoid this may be constant. Inability to move the joint freely as in walking to the toilet. There may be redness and warmth over the joint.

The usual picture of a person afflicted with osteoarthritis is your grandmother or grandfather with painful knees or backs, although it is known that the disease can affect younger persons also. The joints most commonly involved are the knees, spine, thumb and distal most joints of the fingers. In India and generally in Asians, knees are commonly affected by arthritis.
Symptoms range from stiffness to severe swelling and inability to move if the large weight bearing joints are affected. In the spine, it results in back and neck pain and sciatica or arm pain. Sciatic pain is referred pain from the spine, and can be mistaken by the patient to be arising from the knee. It usually travels along the back of the thigh and calves to the feet.
Risks – Obesity, Malalignment of the knees. Examples are knock knees and bowlegs. Pre-existing injuries resulting in ligamentous or meniscal (semilunar cartilage)damage. Smoking, there is a definite correlation between smoking and arthritis.

Rheumatoid arthritis-
It is an immunological disorder caused by a failure of the immune system to recognise some of its own tissues as own. It is an inherited disorder. The patient experiences pain over several joints on both sides and in the same limb. There may swelling over the elbows. The knees can be involved along with others. The disease can cripple young patients. The typical picture is that of a relatively young person with crippled hands and other joints.

It usually affects elderly men and women after menopause. It is due to deposition of uric acid crystals (a waste product of protein metabolism) in the joints. It affects the big toe, elbows, knees and finger joints.

Exercise keeps the joints moving and tones up the muscles about the joint. Weight loss can benefit overweight individuals with knee and ankle problems. Local heat like a warm towel or a hot water bottle relieves pain. Simple medicines as Paracetamol should be the first line of drugs prescribed. Later, when pain is more severe non-steroidal inflammatory drugs can be used. Intra–articular injections can control the swelling and pain in a joint afflicted by rheumatoid or osteoarthritis. When the disease is advanced and ease of movement becomes a nightmare, surgery is recommended. Surgery may consist of osteotomies or joint replacement. Joint replacement can be a total knee replacement in the elderly or a unicondylar replacement whichh replaces half the joint in younger patients. Knee arthroplasty has become a very rewarding and cost effective procedure as proved over the last twenty years. For rheumatoid arthritis not controlled by drugs alone, and where the cartilage is reasonably intact, a medical or surgical synovectomy can be done. (removal of the inflamed lining of a joint). Ultimately the disease progresses to end stage destruction, necessitating bilateral total knee replacements. © Copyright 2000-2001