is inflammation of one or more joints. A joint is the area where two bones meet. There are over 100 different types of arthritis.
Common types of arthritis include
Osteoarthritis
Gout
Psoriatic arthritis
Rheumatoid arthritis
Symptoms
Arthritis causes joint pain, swelling, stiffness, and limited movement. Symptoms can include:

Joint pain

Joint swelling

Reduced ability to move the joint

Redness of the skin around a joint

Stiffness, especially in the morning

Warmth around a joint
Signs and tests
 joint deformity. This may be a sign of severe, untreated rheumatoid arthritis.

Blood tests and joint x-rays are often done to check for infection and other causes of arthritis.
 remove a sample of joint fluid with a needle and send it to a lab for examination
Treatment: goal - reduce pain, improve function, prevent further damage. underlying cause cannot usually be cured.
LIFESTYLE CHANGES are the preferred treatment for osteoarthritis and other types of joint inflammation. Exercise can help relieve stiffness, reduce pain and fatigue, and improve muscle and bone strength. Exercise programs may include:

Low-impact aerobic activity (also called endurance exercise)

Range of motion exercises for flexibility

Strength training for muscle tone
Physical therapy may be recommended. This might include:

Heat or ice

Splints or orthotics to support joints and help improve their position; this is often needed for rheumatoid arthritis

Water therapy

Massage
Other recommendations:

Get plenty of sleep. Sleeping 8 to 10 hours a night and taking naps during the day can help you recover from a flare-up more quickly and may even help prevent flare ups.

Avoid staying in one position for too long.

Avoid positions or movements that place extra stress on your sore joints.

Change your home to make activities easier. Try stress-reducing activities, such as meditation, yoga, or tai chi.

Eat a healthy diet full of fruits + vegetables, which contain important vitamins and minerals, especially vitamin E.

Eat foods rich in omega-3 fatty acids

Apply capsaicin cream over your painful joints.

Lose weight, if you are overweight. Weight loss can greatly improve joint pain in the legs and feet.
MEDICATIONS

Acetaminophen (Tylenol) is usually tried first Do not take more than the recommended dose or take the drug along with a lot of alcohol. Doing so may damage your liver.

Aspirin, ibuprofen, (Advil) or naproxen(Aleeve) are non-steroidal anti-inflammatory drugs (NSAIDs) that can relieve arthritis pain. However, they have many potential risks, especially if used for a long time. Potential side effects include heart attack, stroke, stomach ulcers, bleeding from the digestive tract, and kidney damage.
Prescription medicines include:

Biologics are used for the treatment of autoimmune arthritis. They include etanercept (Enbrel), infliximab
(Remicade), adalimumab (Humira), abatacept (Orencia), rituximab (Rituxan), golimumab (Simponi), certolizumab (Cimzia), and tocilizumab (Actemra). These drugs can improve the quality of life for many patients, but can have serious side effects.

Corticosteroids ("steroids") help reduce inflammation; may be injected into painful joints or given by mouth.


Disease-modifying anti-rheumatic drugs (DMARDs) are used to treat autoimmune arthritis. They include methotrexate, gold salts, penicillamine, sulfasalazine, and hydroxychloroquine.

Immunosuppressants such as azathioprine or cyclophosphamide are used to treat patients with rheumatoid arthritis when other medications have not worked.
SURGERY AND OTHER TREATMENTS

Arthroplasty to rebuild the joint

Joint replacement, such as a total knee joint replacement
(OA) is the most common joint disorder.
Osteoarthritis is caused by 'wear and tear' on a joint.

Cartilage breaks down and wears away; bones rub together, causing pain, swelling, and stiffness.

Bony spurs or extra bone may form around the joint
Often, the cause of OA is unknown; may be related to aging. Symptoms usually appear in middle age. Almost everyone has some symptoms by age 70,but may be minor. Before 55, OA occurs equally in men & women. After 55, more common in women.

OA tends to run in families

Being overweight increases the risk of OA in the hip, knee, ankle, and foot

Fractures or other joint injuries can lead to OA later in life

Long-term overuse at work or in sports can lead to OA
Symptoms
Pain and stiffness in the joints are most common symptoms. pain is worse after exercise and when placing weight or pressure on the joint. Joints become stiff and harder to move over time; a rubbing, grating, or crackling sound with movement. The phrase "morning stiffness" refers to the pain and stiffness people feel when they first wake up in the morning. Stiffness usually lasts for 30 minutes or less. It is improved by mild activity that "warms up" the joint. During the day, the pain may get worse with activity and feel better when you are resting. After a while, the pain may be present when you're resting. It may even wake you up at night.
Signs and tests
No blood tests are helpful in diagnosing OA.
An x-ray of affected joints will show a loss of the joint space. In advanced cases, there will be a wearing down of the ends of the bone and bone spurs.
OA cannot be cured. It will also most likely become worse over time. However, your OA symptoms can be controlled.
While you can always have surgery, other therapies can improve your pain and make your life much better. Although these treatments cannot make the arthritis go away, they can often delay surgery.
MEDICATIONS
Over-the-counter pain relievers, which you can buy without a prescription, can help with OA symptoms.

Most doctors recommend acetaminophen (Tylenol) first, because it has fewer side effects than other drugs.

If your pain continues, your doctor may recommend non-steroidal anti-inflammatory drugs (NSAIDs).

Corticosteroids injected right into the joint can also be used to reduce swelling and pain. However, relief only lasts for a limited time. More than two or three injections a year may be harmful.
Many people use over-the-counter remedies such as glucosamine and chondroitin sulfate have NOT been shown to be effective.
Capsaicin (Zostrix) skin cream may help relieve pain. You may feel a warm, stinging sensation when you first apply the cream. This sensation goes away after a few days of use. Pain relief usually begins within 1 - 2 weeks.
Artificial joint fluid (Synvisc, Hyalgan) can be injected into the knee. It may relieve pain for 3 - 6 months.
LIFESTYLE CHANGES
Exercise helps maintain joint and overall movement.
PHYSICAL THERAPY
SURGERY

Rheumatoid arthritis (RA) is a long-term disease that leads to inflammation of the joints and surrounding tissues. It can also affect other organs.
Causes, incidence, and risk factors
The cause of RA is unknown. It is an autoimmune disease, which means the body's immune system mistakenly attacks healthy tissue. RA can occur at any age, but is more common in middle age. Women get RA more often than men.
Infection, genes, and hormone changes may be linked to the disease.
Symptoms
RA usually affects joints on both sides of the body equally . Wrists, fingers, knees, feet, and ankles are the most commonly affected. The disease often begins slowly, usually with only minor joint pain, stiffness, and fatigue.
Joint symptoms may include:

Morning stiffness> 1 hour, is common. Joints may feel warm, tender, and stiff when not used for an hour.

Joint pain is often felt on the same joint on both sides of the body.

Over time, joints may lose their range of motion and may become deformed.
Other symptoms include:


Chest pain when taking a breath (pleurisy)
Dry eyes and mouth (Sjogren syndrome)

Eye burning, itching, and discharge

Nodules under the skin (usually a sign of more severe disease)

Numbness, tingling, or burning in the hands and feet
Signs and tests
There is not test that can determine for sure whether you have RA. Most patients with RA will have some abnormal test results, although for some patients, all tests will be normal.


Rheumatoid factor test
Anti-CCP antibody test
RA usually requires lifelong treatment, including medications, physical therapy, exercise, education, and possibly surgery.
Early, aggressive treatment for RA can delay joint destruction.
MEDICATIONS
Disease modifying antirheumatic drugs (DMARDs) : first drugs tried in patients with RA. in addition to rest, strengthening exercises, and anti-inflammatory drugs.

Methotrexate (Rheumatrex). Leflunomide (Arava) and sulfasalazine ******serious side effects
Anti-inflammatory medications : (NSAIDs), such as ibuprofen and naprosen.---work well, long-term use can cause stomach problems, such as ulcers and bleeding, and possible heart problems.

Celecoxib (Celebrex) = anti-inflammatory drug; labeled w/strong warnings about heart disease and stroke.
Antimalarial medications : includes hydroxychloroquine (Plaquenil) and sulfasalazine (Azulfidine
Corticosteroids : work very well to reduce joint swelling and inflammation. ; long-term side effects,
BIOLOGIC AGENTS: Biologic drugs are designed to affect parts of the immune system that play a role in the disease
They may be given when other medicines for rheumatoid arthritis have not worked Most of them are given either under the skin (subcutaneously) or into a vein (intravenously). There are different types of biologic agents:

White blood cell modulators include: abatacept (Orencia) and rituximab (Rituxan)

Tumor necrosis factor (TNF) inhibitors include: adalimumab (Humira), etanercept (Enbrel), infliximab
(Remicade), golimumab (Simponi), and certolizumab (Cimzia)

Interleukin-6 (IL-6) inhibitors: tocilizumab (Actemra)
Biologic agents can be very helpful in treating rheumatoid arthritis. However, people taking these drugs must be watched very closely because of serious risk factors: