Unmasking The Many Faces Of Arthritis

By Jan Howard

Arthritis, the inflammation of joints that makes it difficult to perform routine tasks, affects nearly 40 million Americans, or one in every seven people.

 Arthritis, lupus, and Lyme disease were among topics discussed April 28 by Dr Jerry A. Greene during a program sponsored by the Parish Nurse Ministry of St Rose of Lima Church.

Dr Greene, a rheumatologist who specializes in juvenile and adult arthritis, discussed the signs, symptoms, preventative measures, and current treatments for these diseases, as well as tendonitis and bursitis. He is a member of Arthritis Associates of CT/NY, with an office on Hospital Avenue in Danbury.

There are more than 100 types of arthritis, Dr Greene said, including spondylitis, gout, Lyme, rheumatoid arthritis, lupus, and degenerative arthritis.

“We’re the Sherlock Holmes of the medical profession,” he said of rheumatologists. “When people don’t know, they send you to us.

“Rheumatoid arthritis is a degenerative joint disease,” he said. A chronic illness, rheumatoid arthritis is characterized by chronic inflammation of the joints. It can also cause inflammation of tissues in other areas of the body. Because it can affect multiple organs, it is referred to as a systemic illness. It affects mostly the small joints in the wrists, hands, feet, and neck.

It affects three percent of the population and its peak age is from 25 to 50, with women three times more likely to suffer from it than men.

“The synovial lining becomes inflamed, and leads to deformities and pain,” Dr Greene said. “It eats the cartilage and bone away.”

Degenerative arthritis, also known as osteoarthritis, is “the wear and tear arthritis,” Dr Greene said. It is noninflammatory and is the result of aging and loss of the cartilage of the joints. It is the most common form of arthritis, usually affecting the hands, feet, spine, and large weight-bearing joints, such as the hips and knees.

Arthritis may be caused by genetic predisposition, inflammation, trauma, hormonal factors, age, and joint instability.

Women are afflicted with arthritic diseases more than men, and the women to men ratio for lupus is six to one. Gout, however, is more prominent in men, he said.

Lupus is a chronic inflammatory disease caused by an autoimmune condition, Dr Greene said. It is more common in people of African descent. It can cause systemic disease, such as kidney disease, and joint involvement. The first symptom is often a butterfly-shaped rash.

Gout is joint inflammation due to elevated deposits of uric acid crystals in the joint fluid and lining. It is painful and affects the fingers, wrists, and elbows.

Warning signs for arthritis include persistent pain, stiffness, and possibly swelling around joints. In extreme cases, it can cause deformity, loss of function, and systemic illness. The initial damage takes place where two bones meet, Dr Greene said.

Inflammations of the soft tissue around joints include tendonitis or bursitis. A bad shoulder, Dr Greene said, can be the result of tendonitis or bursitis and can lead to a condition known as “frozen shoulder.”

Dr Greene explained that bunions, localized, painful swelling at the base of the big toe, can be related to inflammation of the nearby bursa or degenerative arthritis. Bunions most commonly affect women.

“They can be quite painful, but can be corrected by surgery,” he said.

 Ankylosing spondylitis is a type of arthritis that causes chronic inflammation of the spine. It is more common in men, especially younger men, he said, and causes a hunched over posture and inflammation of the eyes.

“Fibromyalgia is characterized by chronic muscular aches, pain, and stiffness,” Dr Greene said. Treatment includes a combination of education, stress reduction, exercise, and medication.

Lyme disease is the most common vector borne illness in the United States, he said. Transmitted to humans by the deer tick, Lyme disease may first appear as a rash and flulike symptoms and joint pain. It can infect many different types of tissues and have cardiac, neurological, and arthritic effects.

Early treatment with antibiotics for three to six weeks is the preferred treatment.

“Don’t wait for the test,” Dr Greene said. “If you have the rash, treat it. Early treatment prevents later manifestations.”

To guard against tick bites, Dr Greene advised wearing protective, light-colored clothing, such as a long sleeved shirt, pants tucked into socks, and a hat.

If a tick is found on the body, do not burn or douse it with alcohol, he said. Use tweezers to remove it and then wash the area with alcohol.

In most arthritic conditions, exercise is generally good, Dr Greene said, especially range of motion exercises. If a joint is inflamed, however, rest it, he advised.

Dr Greene said when medical treatment is not helping, the rheumatologist helps people to decide when joint replacement should be considered.