Reiter’s SyndromeReiter’s syndrome is a combination of urethritis, conjunctivitis, and arthritis. The arthritis affects the spine and peripheral joints. The disease occurs most commonly in young male adults, and the first attack usually lasts only a matter of weeks or months.Although Reiter’s syndrome is not considered a venereal disease, it appears to result from infection or exposure to an infectious agent during sexual contact. Research has shown that the majority of patients with the disease have genetic predisposition to it.Polymyalgia RheumaticaPolymyalgia rheumatica usually afflicts people aver the age of 50; it causes stiffness and severe aching in the shoulders and hips. Sometimes other joints ache as well, and a few may be swollen. If the disorder is not diagnosed and treated early, symptoms may worsen and include fever, fatigue, weight loss and inflammation of the arteries. On rare occasions, the artery to the eye is affected, resulting in blindness.The cause of polymylagia is unknown. Without treatment, the disease may last for three years or more and can involve considerable pain and disability. Fortunately, the condition is dramatically relieved almost immediately with corticosteroid treatment. Prednisone is generally given and most patients are well within days and can resume normal activities. The drug does not cure the disease, but it eliminates the symptoms. Long-term treatment is usually necessary. The disease tends to disappear after a period of months or years.Gout
Gout is the easiest form of arthritis to detect and treat and the most understood. It most commonly affects the joints of the feet, particularly the big toe, although other joints are frequently involved. Most cases of gout occur in men. It is caused by excess uric acid deposited in the tissues. Crystals of uric acid form in the joints causing inflammation and severe pain.
Drugs such as probenecid and allopurinol are used to reduce the excessive amount of uric acid in the blood and tissue. Colchicine is often used to relieve pain during an attack and to help prevent recurrences. Since gout is affected to some extent by lifestyle, patients should be encouraged to initiate some management themselves. They may need to avoid or limit their consumption of alcoholic beverages, and should maintain a normal weight, get sufficient exercise, and try to avoid using drugs that are not absolutely necessary, as they may elevate the uric acid level.
Ankylosing Spondylitis
Ankylosing spondylitis (AS) is an inflammatory arthritis of the spine. It may be a systemic disorder, and it affects males more often than females. Diagnosis is usually made during young adulthood. The disorder is characterized by back pain, stiffness, and loss of spinal mobility due to involvement of spinal joints. Later these joints tend to become fused and rigid. The hips and shoulders may also become inflamed and stiff.
While not fatal, this is a serious disease, which if left untreated can result in permanently deformed posture. In its initial stages, AS can be confused with many other causes of chronic back pain. Consequently, those afflicted with the disease are frequently misdiagnosed. They can spend thousands of dollars over a period of years in search of a proper diagnosis, all the while their symptoms are worsening.
The disease is treated with pain-relieving and anti-inflammatory drugs. Exercise, posture training, and orthopedic correction are also important aspects of therapy. An inherited blood component known as HLA-B27 occurs in over 90% of patients with spinal arthritis. This component is therefore now considered to be a ‘marker’ or early warning sign for identifying those who may develop the disease in the future. About one-fifth of persons with the marker develop arthritis of the spine.
Certain antirheumatic drugs are effective in combating spinal inflammation. Practice of appropriate exercises and development of constructive habits of body use in everyday activities are significant preventive measures as AS progresses. For this reason, early recognition of the disease is important.
Juvenile Arthritis
Juvenile arthritis, for the most part, is similar to arthritis in adults. It is estimated that 250,000 young people in the US have some form of arthritis.
The complications of juvenile arthritis can be quite variable. These diseases cause growth disturbances and result in high fever and skin rash more frequently than is the case among older patients. Disorders in other body tissues and organs also accompany the disease. Some 30% of patients develop permanent joint changes. The majority of cases can be controlled with proper treatment. Aspirin or one of its newer equivalents are frequently prescribed as they have the fewest side effects.
Lyme Disease
Lyme disease is caused by a tick-borne spirochete, Borrelia burgdorferi which was isolated in 1982 by a scientist at the National Institute of Allergy and Infectious Diseases (NIAID). The disease was first identified in 1975 in Connecticut; it has been reported in thousands of people living along the Atlantic coast, in some Midwestern and Western states, and in numerous foreign countries. The first sign of infection is usually a crimson rash shaped somewhat like a bull’s eye. Symptoms can progress to chills, fatigue, and backaches. If left untreated, a second set of symptoms can develop, including severe headaches, shortness of breath, irregular heartbeat and dizziness. Third-stage symptoms, occurring as much as two years after infection, can include arthritis-like swelling of the joints, usually painful and sometimes disabling. Inspecting oneself frequently for ticks and removing them promptly may lower the risk of infection and should be recommended to residents of regions where Lyme disease is prevalent. When the disease is treated early with antibiotics, physicians believe that most people recover without developing complications. Left untreated, there is general agreement that the risk of long-term problems increases, but just how much is a matter of debate.
Coping with Arthritis
Arthritis should be diagnosed and treated by a qualified physician; a person with arthritis should not try to treat themselves. The first place to start is with a family doctor, either a general practitioner or an internist. She or he may refer the patient to a rheumatologist or, in some cases, to an orthopedic surgeon.
Patients should be wary of remedies and devices that have not been scientifically established. Each year people spend hundreds of millions of dollars on drugs, devices, and treatments for arthritis that have not been proven effective, and that in some cases can actually be harmful. Contrary to popular belief, there is no such thing as a special arthritis diet. Although in some cases certain adjustments in normal diet patterns should be made, no diet in itself will cure arthritis.
The arthritis patient should, however, get sufficient rest, particularly during periods when joints are painful and inflamed. Proper exercise is also very important. Therapeutic exercises, individually prescribed for the specific condition, are essential not only for the maintenance of joint function, but also for strengthening the muscles that support the joints.
For those patients who are unable or unwilling to exercise by themselves, physical therapy can be administered in a hospital clinic or at home. The therapist may provide various forms of treatment with heat or massage, or teach patients how to exercise joints by moving them through their full range of motion, or teach them how to maintain good posture. After proper medical attention, patients can learn everything they need to know for care at home, whether independently or with the assistance of family members.
To aid the arthritic person in performing activities of daily living – dressing, eating, cooking, writing, and so forth – there are numerous simple and inexpensive devices that can be very helpful and can make the difference between self-sufficiency and dependence. Long-handled combs, shoehorns, kitchen utensils, and heightened chairs and toilet seats are just a few examples. Clothes are available without buttons, snaps, or hooks, which are sometimes impossible to manipulate with stiff, swollen hands.
