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Musculoskeletal complaints including arthritis accounts for more
than 310,000,000 outpatient visits per year. Many of these
problems which cause patients to seek medical attention usually do
not require an extensive amount of treatment or evaluation. They
usually receive symptomatic treatment with reassurance. However,
some complaints do need further evaluation, so proper diagnosis
and testing is required.
A complete evaluation of the patient's signs and symptoms must be completely evaluated because there are many different types of arthritis. Different types of arthritis have different treatments, therefore, it is important for the patient to be observant about the symptoms which present. A description about several forms of arthritis will be given. A patient can ask the following questions to himself. Did the pain start suddenly, or has it been chronic? Is the pain in or near my joint? Do I have redness or swelling of the joint? Do I have one or more painful joints? Is the joint pain symmetric on both sides of my body? What time of day do I feel my arthritis pain? The most common type of arthritis is osteoarthritis, and it affects the knee most commonly. This is a chronic type of arthritis that is found in joints asymmetrically. You may need to have blood tests performed as well as X-rays done on the specific joints. The first type of treatment may include weight loss, rehabilitation depending on the severity, and diet modifications. Next, acetaminophen may be tried or non-steroidal anti- inflammatory drugs (NSAID) as needed. If these are not adequate, steroid injections may work. The next type of arthritis is gouty arthritis. This type can have swelling ranging from only minor to major swelling with redness. Severe pain is sometimes associated. If there is swelling of the joint, the doctor will take a needle aspirate sample from the joint to make a diagnosis. The joint which is usually affected is the big toe. Treatment of gout involves an NSAID called indomethacin. Colchicine is another form of treatment. Men are usually affected more, and certain predisposing factors to developing gout include alcohol intake, certain medications, trauma, etc. Rheumatoid arthritis is an inflammatory disease which affects many joints. It is a chronic disease, and other associated illness may develop along the course of the disease. The patient usually complains of fatigue and weakness at the time of diagnosis. They may report morning stiffness of joints which is they are stiff in the morning. Resolution occurs with movement as the day progresses. The evaluation includes more specific blood tests as well as an X-ray of the joints. Treatment is with medications such as NSAIDs or methotrexate. Septic arthritis is an infected joint. The joint will be very swollen and red with inflammation. The patient may complain of fever with the infected joint. Certain bacteria cause this infection, and the most common type of organism is usually obtained through sexual transmission. So, sexual history should be obtained. To diagnose the causative organism, a joint aspirate will be obtained. The patient will need to be admitted to the hospital and be given intravenous antibiotics. The diagnosis of arthritis relies on the different characteristics of these illnesses. Proper treatment can be administered once the correct diagnosis is made. |