arthritides

Arthritides are a diverse group of conditions characterized by inflammation of one or more joints, leading to pain, swelling, stiffness, and reduced function. The term encompasses inflammatory, autoimmune, crystal-induced, infectious, metabolic, and degenerative joint diseases, as well as juvenile forms. The most common examples include osteoarthritis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, gout, pseudogout, and septic arthritis. Some conditions preferentially affect certain joints or systems and may have extra-articular features such as fatigue, skin changes, or eye involvement.

Osteoarthritis is a degenerative joint disease due to cartilage wear and mechanical factors; management focuses on activity modification, weight management, analgesia, physical therapy, and when needed, intra-articular injections or surgery. Inflammatory arthritides like rheumatoid and psoriatic arthritis involve autoimmune mechanisms; early initiation of disease-modifying antirheumatic drugs (DMARDs) and, if needed, biologic agents, improves outcomes and can halt progression. Gout results from uric acid crystal deposition and is treated with urate-lowering therapy and anti-inflammatory meds. Septic arthritis requires prompt antibiotics and drainage. Reactive arthritis follows infection. Juvenile idiopathic arthritis affects children with varied phenotypes.

Diagnosis relies on history, exam, lab tests (inflammatory markers ESR/CRP), serology (RF, anti-CCP for rheumatoid arthritis, HLA-B27 for spondyloarthropathies), urine or synovial fluid analysis, and imaging (X-ray, ultrasound, MRI).

Treatment aims to relieve pain, preserve joint function, and slow disease progression. Nonpharmacologic measures include physical therapy and exercise, weight control, and joint protection. Pharmacologic options include NSAIDs, acetaminophen, topical agents, corticosteroids, DMARDs (eg, methotrexate, sulfasalazine, hydroxychloroquine), and biologics; gout uses urate-lowering therapy and NSAIDs/colchicine; septic arthritis requires antibiotics.

Epidemiology and prognosis vary by disease; arthritides are a common cause of disability, especially in older adults. Early diagnosis and multidisciplinary management improve outcomes.