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arthritis, painful inflammation of a joint or joints of the body, usually producing heat and redness. There are many kinds of arthritis. In its various forms, arthritis disables more people than any other chronic disorder. The condition can be brought about by nerve impairment, increased or decreased function of the endocrine glands, or degeneration due to age. Less frequently, it is caused by infection (tuberculosis, gonorrhea, Lyme disease, rheumatic fever).
Rheumatoid arthritis, an autoimmune disease of unknown cause, is the most crippling form. Women are much more susceptible to it than men. Although rheumatoid arthritis usually appears between the ages of 25 and 50, it also occurs in children. Osteoarthritis, the most common type, occurs usually in people over 50. It tends to be more severe when the joints have been strained by obesity or overwork. Gout, the third most common form of arthritis, affects men almost exclusively.
Symptomatic treatment for arthritis includes use of heat, physical therapy, and nonsteroidal anti-inflammatory drugs such as a cox-2 inhibitor (Celebrex), aspirin, ibuprofen, and naproxen. Remission of symptoms can sometimes be achieved with methotrexate, gold salts, penicillamine, and short-term cortisone, but they often have undesirable side effects. Orthopedic surgery, including artificial joint implantation, may be done in severe cases.
a group of joint diseases that are of infectious origin or arise as a result of disruption of the nutrition of the joint. Arthritis can be an independent disease or a manifestation of some other disease. Symptoms that may indicate arthritis include pain, redness, swelling, deformation, impaired joint function, increase of local (cutaneous) temperature above the joint, and fever. In different forms of the disease the symptoms appear in various combinations.
The Ninth International Congress of Rheumatologists in 1957 accepted a working classification and nomenclature of joint diseases; this was reflected in the classification and terminology of joint diseases developed in the USSR in the same year. The classification was based on etiological (causal), pathogenetic (according to the mechanism of evolution), and clinical-anatomical principles. The disease of one joint is monoarthritis; of several joints, polyarthritis. Arthritis can be acute and chronic, with or without effusion (serous, suppurative, or hemorrhagic). According to its origin, arthritis is divided into traumatic, infectious, degenerative, arthritis associated with other diseases, and rare forms of joint lesions. The infectious forms of arthritis include rheumatic fever (Sokol’skii-Bouillaud’s disease); arthritis associated with the presence in the organism of one or another specific infection, such as tuberculous, syphilitic, dysenteric, gonorrheal, septic, and brucellosis arthritis; infectious nonspecific arthritis; and ankylosing spondylitis (von Bechterew-Strumpell’s disease). Degenerative arthritis arises as a result of metabolic disturbance and includes gouty arthritis, arthritis accompanying Kashin-Beck disease and hemophilia, rheumatoid arthritis, degenerative (hypertrophic) arthritis (osteoarthritis), and arthritis resulting from changes in the endocrine system (climacteric, thyrotoxic, and so on). This group also includes arthritis associated with vitamin deficiency (scorbutic arthritis), physical over-exertion, chilling, and unsanitary conditions at home and on the job (arthritis in miners, transport workers, and metallurgical workers). Traumatic arthritis includes arthritis occurring after open (penetrating) or closed joint injury, as well as in cases of repeated mild traumatism (vibration arthritis). Arthritis can also be associated with diseases such as systemic lupus erythematosus, periarteritis nodosa, leukemia and other blood diseases, psoriasis, and diseases of the nervous system.
In some cases arthritis progresses with little change in the joints; in other cases there is significant change in the synovial sheath, cartilage, bone, and joint capsule and ligaments. Arthritis can terminate in complete restoration of normal joint function, but it can also lead to disfigurement of the joint and its partial or complete immobilization.
Treatment consists of isolation of the factor causing arthritis or treatment of the disease that caused its development. Depending on the character of the arthritis, antibiotics, hormone preparations, anti-inflammatory and analgesic drugs, physiotherapy, or therapeutic gymnastics are prescribed. Surgical treatment is widely used; this consists of resection of the capsule, arthroplasty, arthrotomy, and arthrodesis. Treatment is also carried out at health resorts (including Tskhaltubo, Piatigorsk, Saki, and Evpatoriia in the USSR).
In the prevention of arthritis, sanitation measures for work and daily life are very significant. These measures include improvement of working methods, labor protection, safety technology, elimination or lessening of professional hazards, and observation of hygiene in dwellings and dress.
REFERENCESKushelovskii, B. P., M. A. Lasinovskii, and S. M. Ryss. Bolezni sustavov. Revmatizm. Avitaminozy. Moscow, 1961. (Bibliography.)
Leporskii, A. A. Lechebnaia fizicheskaia kul’tura pri bolezniakh obmena veshchestv i zabolevaniiakh sustavov. Moscow, 1960.
Nesterov, A. I., and Ia. A. Sigidin. Klinika kollagenovykh boleznei, 2nd ed. Moscow, 1966.