Arthritis: Types, Symptoms, Causes, and Management Overview

Arthritis means "joint inflammation" (arthro- joint + -itis inflammation). It encompasses >100 conditions affecting joints, surrounding tissues, and connective tissue. It affects all ages—two-thirds of patients are <65—and is a leading cause of disability.

Common Symptoms

• Joint pain (arthralgia) — mechanical (worse with use) vs. inflammatory (worse at rest/morning)
• Stiffness — duration differentiates: OA <30 min; inflammatory >1 hr
• Swelling — bony (osteophytes) vs. soft (synovitis/effusion)
• Redness/warmth — inflammatory hallmark
• Reduced ROM, crepitus, instability, deformity (late)

Major Types

Underlying Causes (Multifactorial)

• Genetics: HLA-DRB1 (RA), HLA-B27 (AS), multiple GWAS loci.
• Age: Cumulative joint loading, chondrocyte senescence.
• Sex: RA, SLE, OA (knee/hand) > women; gout, AS > men.
• Obesity: Mechanical load + adipokines (leptin, adiponectin) → inflammation.
• Trauma / overuse: Post-traumatic OA.
• Infection: Reactive arthritis (post-GI/GU), Lyme, viral.
• Metabolic: Diabetes (AGEs), hemochromatosis (CPP).

Management Principles

• Accurate diagnosis → targeted therapy.
• Non-pharmacologic: Exercise (aerobic + resistance), weight management, PT/OT, assistive devices, self-management education.
• Pharmacologic: Analgesics (acetaminophen), NSAIDs, DMARDs (csDMARDs, bDMARDs, tsDMARDs), corticosteroids, urate-lowering, biologics.
• Interventional: Intra-articular steroids, HA, PRP, genicular nerve ablation.
• Surgical: Arthroscopy, osteotomy, arthroplasty (joint replacement), fusion.

Early diagnosis and treat-to-target strategies preserve joint function and quality of life.

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Type	Category	Hallmarks
Osteoarthritis (OA)	Degenerative	Cartilage loss, osteophytes, subchondral sclerosis; asymmetric, weight-bearing joints, DIP/PIP (Heberden's/Bouchard's nodes)
Rheumatoid Arthritis (RA)	Autoimmune	Symmetrical polyarthritis (MCP, PIP, wrist), morning stiffness >1 hr, RF/anti-CCP+, systemic, erosions
Psoriatic Arthritis (PsA)	Spondyloarthropathy	Asymmetric, DIP, dactylitis, enthesitis, nail pitting, skin psoriasis, HLA-B27 subset
Ankylosing Spondylitis (AS)	Axial SpA	Inflammatory back pain (night/morning, improves w/ exercise), sacroiliitis, HLA-B27+, uveitis
Gout	Crystal (MSU)	Acute monoarthritis (1st MTP), tophi, hyperuricemia
Pseudogout (CPPD)	Crystal (CPP)	Knee/wrist, chondrocalcinosis on X-ray
Septic Arthritis	Infectious	Hot, swollen, exquisitely tender joint + fever — EMERGENCY
Juvenile Idiopathic Arthritis (JIA)	Pediatric autoimmune	Onset <16 yr; subtypes: oligo, poly, systemic, enthesitis-related