| There is an old joke. It goes like this: "Neurologists | | | | weight-bearing joints such as the neck, low back, |
| diagnose the untreatable while rheumatologists treat | | | | hips, and knees. It tends to occur in older people. |
| the undiagnosable." Nothing could be truer than when | | | | While it may progress, it does so relatively slowly. It |
| it comes to what is termed "inflammatory arthritis." | | | | is rarely, if ever, associated with constitutional |
| Most rheumatologists tend to divide arthritis into two | | | | symptoms. In fact if constitutional symptoms are |
| major categories: inflammatory and non-inflammatory. | | | | present, then either the patient has more than |
| The latter category is also termed "degenerative" | | | | non-inflammatory arthritis or has another illness in |
| arthritis. | | | | addition to their arthritis. This is the type of arthritis |
| The major distinction is that inflammatory types of | | | | people often associate with getting older. |
| arthritis have a significant amount of inflammatory | | | | Non-inflammatory types of arthritis may also be |
| cells that attack the joints. These types of arthritis | | | | confusing some times. An example is a condition like |
| tend to cause more symptoms, particularly stiffness | | | | fibromyalgia where the pain occurs pretty much all |
| and pain. They also tend to be progressive. | | | | over. Symptomatic and subjective joint swelling may |
| Oftentimes inflammatory types of arthritis are | | | | make the clinical diagnosis difficult. |
| associated with constitutional symptoms, meaning low | | | | The distinction between inflammatory and |
| grade fever, weight loss, and fatigue. Inflammatory | | | | non-inflammatory arthritis is made on the basis of a |
| types of arthritis can also cause significant damage to | | | | careful history, physical examination, laboratory tests, |
| internal organs. Disability and early death may be a | | | | and imaging procedures such as magnetic resonance |
| consequence of some types of inflammatory arthritis. | | | | imaging (MRI) and ultrasound. |
| Examples of inflammatory arthritis are rheumatoid | | | | Sometimes a patient can have both types of arthritis. |
| arthritis, systemic lupus erythematosus, psoriatic | | | | For instance it is not uncommon for a patient with |
| arthritis, gout, infectious arthritis, and ankylosing | | | | longstanding rheumatoid arthritis to also have |
| spondylitis. | | | | degenerative arthritis (osteoarthritis) in a knee or hip. |
| Inflammatory types of arthritis can strike at any age. | | | | Interestingly, when an arthroscope (small telescope) |
| Inflammatory types of arthritis have typical patterns | | | | is used to visualize the interior of a joint, almost all |
| although theoretically any joint in the body can be | | | | types of arthritis have an inflammatory component |
| affected. | | | | to them. The extent and type of inflammatory |
| Inflammatory forms of arthritis may not be easy to | | | | change though varies from disease to disease. |
| categorize. Sometimes it will be obvious that | | | | The treatment for inflammatory arthritis will vary. |
| inflammation is present and is a prominent component | | | | While anti-inflammatory medicines are sometimes |
| of the symptom complex. However, a specific | | | | helpful, it may be necessary to start disease |
| diagnosis may not be apparent. Eventually most | | | | modifying drug therapy. Again the skill and experience |
| forms of inflammatory arthritis do "declare" | | | | of the arthritis specialist is paramount in determining |
| themselves and ultimately fall into a category. But not | | | | which direction to head. Obviously, if the |
| always! This is a situation where a skilled diagnostician | | | | inflammatory arthritis becomes more well-defined, |
| and clinician is worth their weight in gold! | | | | then treatment becomes easier to define as well. |
| On the other hand, non-inflammatory types of | | | | The key point to remember is that if you do have |
| arthritis cause symptoms based on mechanical | | | | arthritis, it's important to seek the opinion of an |
| factors. Often degenerative arthritis affects | | | | expert arthritis specialist. |