Overview of Arthritis and Gout

Study Notes

Arthritis encompasses various conditions, including osteoarthritis, rheumatoid arthritis, and gout.

Characterized by deposition of monosodium urate (MSU) crystals.
Hyperuricemia is a key factor, with levels exceeding 7 mg/dL in men and 6 mg/dL in women.
Pain, swelling, and inflammation are common symptoms, frequently affecting the big toe (podagra).
Crystals are needle-shaped.
Distinguished from pseudogout by crystal morphology (needle-shaped vs. rhomboid/rod-shaped).
Early diagnosis and management are crucial for preventing long-term joint damage.

Characterized by cartilage breakdown and bone spurs (osteophytes).
Common symptoms include joint pain, stiffness, especially in the morning, and reduced range of motion (ROM).
Affected areas often include hips, knees, hands (especially distal interphalangeal joints).
Cartilage thinning and bone rubbing contribute to symptoms.
Osteophytes develop as the cartilage wears away.
Inflammation is not typically as severe compared to rheumatoid arthritis.
May be associated with joint stiffness, pain, and limited motion; usually worse after activity.
The progression of osteoarthritis is often determined by the presence of osteophytes, joint space narrowing and sclerosis of bones.
Different grading systems categorize the severity of cartilage damage and bone changes.

A chronic autoimmune inflammatory disease affecting joints.
Inflammation leads to joint damage, often symmetrically.
Symptoms often include morning stiffness lasting over 30 minutes, affecting multiple joints.
RA can affect various tissues beyond joints.
Characterized by inflammation of the synovial membrane that lines the joint. This process can damage the cartilage and bone, leading to joint deformities.
RA is often linked to genetic and hormonal factors.
The inflammatory process of RA can impact various organs within the body.
Symptoms frequently include symmetrical swelling and tenderness in multiple joints, accompanied by systemic symptoms such as fever, fatigue, and weight loss.
Possible deformities include boutonniere deformity and swan-neck deformity.

RA often features symmetrical joint involvement, while OA is typically asymmetrical.
In RA, morning stiffness usually lasts longer than in OA.
RA commonly involves systemic manifestations beyond joints.

Dietary modifications are important for gout to manage uric acid levels.
Non-pharmacological therapies include patient education, lifestyle modifications, and exercise programs.
Medications and biological agents (e.g., TNF inhibitors, B-cell blockers, and anti-IL-1 and IL-6 agents) may be prescribed for some types of arthritis.