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What is it about ?
Joint inflammation or arthritis is an inflammatory reaction of the joint. A joint is where 2 bones come together and can change position relative to each other. On the surface, the joint is covered with a layer of cartilage which is enveloped in a sheath, the joint capsule. The inner surface of this capsule is also covered with a mucous membrane which produces a lubricant, the synovial fluid.
Often, inflammation results in more fluid being present in the joint, which prevents it from functioning normally. Swelling, redness, and warmth are other signs that indicate the presence of inflammation.
The causes that can be at the origin of joint inflammation are very numerous. We can classify them into traumatic causes and non-traumatic causes. Traumatic causes are always linked to an accident (for example a sports accident).
Among the non-traumatic causes, we can distinguish infectious and non-infectious forms. In infectious arthritis, there is a virus or bacteria in the joint. The non-infectious forms are by far the most frequent. They include, for example, conditions such as rheumatism and the drop. Sometimes arthritis is part of an underlying condition such as psoriasis or a chronic inflammatory bowel disease.
In a limited number of cases, the cause is impossible to identify. This is called primary (or idiopathic) osteoarthritis.
What is its frequency?
There are 25 cases of arthritis per 10,000 adults, including 8 without a known cause, 5 caused by rheumatism, 5 by gout, 5 by an underlying condition and 2 by infection.
How to recognize it?
Joint inflammation produces the classic symptoms of any inflammation: pain, swelling, local heat, and often redness. Joint stiffness is characteristic of arthritis. There is always a functional limitation, which means that some movements are more difficult or even impossible, by the swelling and the pain.
The inflammation may affect one joint (monoarthritis) or several (polyarthritis). Monoarthritis primarily, but not exclusively, affects large joints such as the knee, hip, and shoulder, while arthritis instead affects smaller joints such as the fingers.
Gout very often starts at the base of the big toe.
Over time, the affected joints can also become deformed. This phenomenon is observed especially in the hands.
How is the diagnosis made?
Given the wide range of possible causes, the diagnosis of arthritis is not always clear from the start. Sometimes a follow-up of a few weeks to a few months is necessary to arrive at a correct diagnosis.
The doctor will question you carefully: have you had an accident, how long have you had symptoms, is this the first inflammation or a relapse, do you have a fever, do you suffer from stiffness after rest, do you have people in your family who suffer from rheumatism, do you suffer from other diseases, …?
Complementary examinations may include:
- a clinical examination of the joint to determine if it is really a question of joint inflammation. Each inflamed joint presents a typical picture of limitation of movement. If there are classic signs of inflammation, arthritis is very likely. The doctor will also pay attention to other joints.
- a puncture aimed at extracting fluid from the joint: in the case of traumatic arthritis, it will mainly be blood; in case of infection, the punctured fluid will be rather cloudy to purulent; and, in rheumatic affections, the liquid will be yellowish transparent. This fluid will be analyzed for white blood cells and uric acid crystals (present in case of gout). It will also be cultured in order to detect possible contamination.
- a blood test targeting the number of white blood cells (increased in case of infection), uric acid (for gout: but may be falsely low or normal during an acute attack), inflammatory factors, etc.
- urinalysis.
- a stool test in case of gastrointestinal problems.
What can you do ?
If you have arthritis, don’t just sit back and do nothing. But don’t take treatment on your own if you don’t know the cause. It may indeed be due to a serious condition.
An ignition always produces heat. Applying ice to the affected joint is therefore always beneficial. Also try not to strain the joint. If necessary, use crutches for a little while.
If you suffer from gout, it is best to avoid foods and drinks high in uric acid. Limit your consumption of alcohol and certain fish (sardines, turbot, herring, anchovies), crustaceans (lobster, mussels), offal (liver, kidneys, sweetbreads), meats (veal fillet, pork or lamb) and vegetables (lentils).
What can your doctor do?
If he knows the cause, the doctor can directly treat the arthritis. It usually starts with giving you anti-inflammatory drugs (eg ibuprofen). In the case of monoarthritis, a infiltration of cortisone can provide quick relief.
There are specific medicines for gout, such as colchicine, but they are not the treatment of first choice. In the event of frequent gout attacks, allopurinol should be started as a disease-modifying treatment. This treatment helps keep uric acid levels in the blood low.
You will be referred to a specialist for further tests if the GP suspects you have infectious or rheumatoid arthritis, polyarthritis or persistent inflammation that does not respond to treatment.
In fact, infectious arthritis generally requires the rapid administration of antibiotic therapy by infusion.
For rheumatic conditions, the disease-modifying treatment can be started to reduce the number of attacks and prevent permanent damage to the joints.
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