Artropati

Artropati, or arthropathy, is a general term for disease or pathology of a joint. It encompasses a broad range of conditions that cause joint pain, swelling, stiffness, and impaired movement. The term is used to describe isolated joint problems as well as systemic diseases that affect multiple joints.

Arthropathies are commonly categorized by underlying mechanism. Degenerative arthropathy refers most often to osteoarthritis, where wear and tear leads to cartilage loss and joint dysfunction. Inflammatory arthropathies include rheumatoid arthritis, psoriatic arthritis, and other autoimmune or autoinflammatory conditions. Metabolic arthropathies arise from abnormal metabolite handling, as seen in gout, pseudogout, or hemochromatosis arthropathy. Infectious arthropathy (septic arthritis) results from joint infection, while post-traumatic or developmental arthropathies follow injury or congenital conditions.

Common examples include osteoarthritis, rheumatoid arthritis, gout, and calcium pyrophosphate deposition disease. Clinical features vary by type but often include joint pain, stiffness (which may be more prominent in the morning in inflammatory forms), swelling, warmth, and reduced range of motion. Red flags include fever, profound swelling, inability to move the joint, or sudden severe pain, which may indicate infection or trauma.

Diagnosis relies on history, physical examination, imaging (X-ray, ultrasound, MRI), and laboratory tests. Lab work may assess inflammatory markers (CRP, ESR), autoantibodies (RF, anti-CCP), uric acid, and infectious workup. Synovial fluid analysis can help distinguish inflammatory, crystal-driven, or septic processes.

Management is tailored to the specific arthropathy. General goals are to relieve pain, maintain joint function, and treat the underlying condition. Nonpharmacologic approaches include physical therapy, weight management, and activity modification. Pharmacologic treatments cover NSAIDs, analgesics, and intra-articular steroids; disease-modifying drugs for inflammatory arthropathies; urate-lowering therapy for gout; antibiotics for septic arthritis. In advanced cases or failure of medical therapy, surgical options such as joint replacement may be considered. Prognosis varies widely by type and response to treatment.