This fact sheet answers basic questions about arthritis and rheumatic diseases. The National Arthritis and Musculoskeletal and Skin Diseases Information
Clearinghouse (NAMSIC) has other fact sheets that provide more information
about specific forms of arthritis and rheumatic diseases. NAMSIC
also has information about exercise and arthritis and diet and arthritis.
At the end
is a list of key words to help you understand the terms used in
this fact sheet. If you have further questions after reading this
fact sheet, you may wish to discuss them with your doctor.
Are Rheumatic Diseases and What Is Arthritis?
more than 100 rheumatic diseases. These diseases may cause pain,
stiffness, and swelling in joints and other supporting structures
of the body such as muscles, tendons, ligaments, and bones. Some
rheumatic diseases can also affect other parts of the body, including
various internal organs.
use the word “arthritis” to refer to all rheumatic diseases. However,
the word literally means joint inflammation; that is, swelling,
redness, heat, and pain caused by tissue injury or disease in the
joint. The many different kinds of arthritis comprise just a portion
of the rheumatic diseases. Some rheumatic diseases are described
as connective tissue diseases because they affect the body’s connective
tissue—the supporting framework of the body and its internal organs.
Others are known as autoimmune diseases because they are caused
by a problem in which the immune system harms the body’s own healthy
tissues. Examples of some rheumatic diseases are provided on the
of Rheumatic Diseases
known as degenerative joint disease, osteoarthritis is the most
common type of arthritis, affecting an estimated 20.7 million
adults in the United States. Osteoarthritis primarily affects
cartilage, which is the tissue that cushions the ends of bones
within the joint. Osteoarthritis occurs when cartilage begins
to fray, wear, and decay. In extreme cases, the cartilage may
wear away entirely, leaving a bone-on-bone joint. Bony spurs (pointy
bulges of bone) may form at the edges of the joint. Osteoarthritis
can cause joint pain, reduced joint motion, loss of function,
and disability. Disability results most often when the disease
affects the spine and the weight-bearing joints (the knees and
arthritis is an inflammatory disease of the synovium, or lining
of the joint, that results in pain, stiffness, swelling, deformity,
and loss of function in the joints. Inflammation most often affects
joints of the hands and feet and tends to be symmetrical (occurring
equally on both sides of the body). This symmetry helps distinguish
rheumatoid arthritis from other types of arthritis. About 1 percent
of the U.S. population (about 2.1 million people) has rheumatoid
is a chronic disorder that causes pain and stiffness throughout
the tissues that support and move the bones and joints. Pain and
localized tender points occur in the muscles and tendons, particularly
those of the neck, spine, shoulders, and hips. Patients may experience
widespread pain, fatigue, and sleep disturbances.
lupus erythematosus (also known as lupus and SLE) is an autoimmune
disease in which the immune system harms the body’s own healthy
cells and tissues. In SLE, this can result in inflammation of
and damage to the joints, skin, kidneys, heart, lungs, blood vessels,
and brain. .
known as systemic sclerosis, the word scleroderma means “hard
skin.” It refers to several diseases that almost always affect
the skin, blood vessels, and joints. A more serious form also
affects internal organs such as the lungs and kidneys. In scleroderma,
there is an abnormal and excessive production of collagen (a fiber-like
protein) in the skin or internal organs.
is the most common form of arthritis in childhood, causing pain,
stiffness, swelling, and loss of function in the joints. The arthritis
may be associated with rashes or fevers, or may affect other parts
of the body.
spondylitis—This type of arthritis primarily affects
the spine, but may also cause arthritis in the hips, shoulders,
and knees. The tendons and ligaments around the bones and joints
in the spine become inflamed, resulting in pain and stiffness,
especially in the lower back. Ankylosing spondylitis tends to
affect people in late adolescence or early adulthood.
type of arthritis results from deposits of needle-like crystals
of uric acid in the connective tissue, joint spaces, or both.
Uric acid is a normal breakdown product of purines, which are
present in body tissues and in many foods. Usually, uric acid
passes through the kidney into urine and is eliminated. If the
concentration of uric acid in the blood rises above normal levels,
sodium urate crystals may form in the tendons, ligaments, and
cartilage of the joints. These needle-like crystals cause inflammation,
swelling, and pain in the affected joint. The joint most commonly
affected is the big toe.
is a general term used to describe forms of arthritis that are
caused by infectious agents, such as bacteria or viruses. Parvovirus
arthritis, gonococcal arthritis, and Lyme disease are examples
of infectious arthritis. In those cases caused by bacteria, early
diagnosis and treatment with antibiotics relieve the arthritis
symptoms and cure the disease.
arthritis—This form of arthritis develops after an
infection involving the lower urinary tract, bowel, or other organs.
It is commonly associated with eye problems, skin rashes, and
mouth sores. Reiter’s syndrome is an example of reactive arthritis.
form of arthritis occurs in some patients with psoriasis, a common
scaling skin disorder. Psoriatic arthritis often affects the joints
at the ends of the fingers and is accompanied by changes in the
fingernails and toenails. Some people also have spinal involvement.
condition involves inflammation of the bursae, small, fluid-filled
sacs that help reduce friction between bones and other moving
structures in the joints. The inflammation may result from arthritis
in the joint or injury or infection of the bursae. Bursitis produces
pain and tenderness and may limit the movement of nearby joints.
(Tendonitis)—This refers to inflammation of tendons
(tough cords of tissue that connect muscle to bone) caused by
overuse, injury, or related rheumatic conditions. Tendinitis produces
pain and tenderness and may restrict movement of nearby joints.
Causes Rheumatic Disease?
of rheumatic diseases vary depending on the type of disease. Researchers
have pinpointed the cause or causes of some rheumatic diseases,
such as infectious arthritis and gout.
of most rheumatic diseases are still under investigation. In osteoarthritis,
excessive stress on the joint, from repeated injury or inherited
cartilage weakness, may play a role. In lupus, rheumatoid arthritis,
and scleroderma, the combination of genetic factors that determine
susceptibility, the influence of certain hormones, and environmental
triggers are believed to be important.
are also studying the risk factors that determine why some people
develop rheumatic diseases and others do not. For example, being
overweight increases the likelihood that a person will develop osteoarthritis.
The chance of developing osteoarthritis also increases with age.
Genes and family history play a role in many rheumatic diseases
including gout, rheumatoid arthritis, lupus, ankylosing spondylitis,
scleroderma, and some others.
conditions, such as lupus, rheumatoid arthritis, scleroderma, and
fibromyalgia, are more common among women (see below for details).
This indicates that hormones or other male-female differences play
a role in the development of these conditions.
Is Affected by Arthritis and Rheumatic Conditions?
40 million people in the United States have arthritis or other rheumatic
conditions. By the year 2020, this number is expected to reach 59
million. Rheumatic diseases are the leading cause of disability
among adults age 65 and older.
affect people of all races and ages. Some rheumatic conditions are
more common among certain populations. For example:
arthritis occurs two to three times more often in women than in
is more common in women than in men.
- Nine out
of 10 people who have lupus are women.
- Nine out
of 10 people who have fibromyalgia are women.
- Gout is
more common in men than in women.
- Lupus is
three times more common in African-American women than in Caucasian
spondylitis is more common in men than in women.
Symptoms of Arthritis
in one or more joints
around the joints that lasts for at least 1 hour in the
or recurring pain or tenderness in a joint
using or moving a joint normally
and redness in a joint
Are the Symptoms of Arthritis?
of arthritis have different symptoms. In general, people who have
arthritis have pain and stiffness in the joints. Some of the more
common symptoms are listed in the box on this page. Early diagnosis
and treatment help decrease further joint damage and help control
symptoms of arthritis and many other rheumatic diseases.
Are Rheumatic Diseases Diagnosed?
rheumatic diseases can be difficult because some symptoms and signs
are common to many different diseases. A general practitioner or
family doctor may be able to evaluate a patient or refer him or
her to a rheumatologist: a doctor who specializes in treating arthritis
and other rheumatic diseases.
will review the patient’s medical history, conduct a physical examination,
and obtain laboratory tests and X rays or other imaging tests. The
doctor may need to see the patient more than once to make an accurate
It is vital
for people with joint pain to give the doctor a complete medical
history. Answers to the following questions will help the doctor
make an accurate diagnosis:
- Is the pain
in one or more joints?
- When does
the pain occur?
- How long
does the pain last?
- When did
you first notice the pain?
- What were
you doing when you first noticed the pain?
- Does activity
make the pain better or worse?
- Have you
had any illnesses or accidents that may account for the pain?
- Is there
a family history of any arthritis or rheumatic diseases?
- What medicine(s)
are you taking?
It may be helpful
for people to keep a daily journal that describes the pain. Patients
should write down what the affected joint looks like, how it feels,
how long the pain lasts, and what they were doing when the pain
Examination and Laboratory Tests
will examine all of the patient’s joints for redness, warmth, deformity,
ease of movement, and tenderness. Because some forms of arthritis,
such as lupus, may affect other organs, a complete physical examination
including the heart, lungs, abdomen, nervous system, and eyes, ears,
and throat may be necessary. The doctor may order some laboratory
tests to help confirm a diagnosis. Samples of blood, urine, or synovial
fluid (fluid found in the joint) may be needed for the tests.
antibody (ANA)—This test checks blood levels of antibodies
that are often present in people who have connective tissue diseases
or other autoimmune disorders, such as lupus. Since the antibodies
react with material in the cell’s nucleus (control center), they
are referred to as antinuclear antibodies. There are also tests
for individual types of ANA’s that may be more specific to people
with certain autoimmune disorders. ANA’s are also sometimes found
in healthy people. Therefore, having ANA’s in the blood does not
necessarily mean that a person has a disease.
or joint aspiration is done to obtain a sample of synovial fluid.
The doctor injects a local anesthetic, inserts a thin, hollow
needle into the joint, and removes the synovial fluid into a syringe.
The test provides important diagnostic information. For example,
the test allows the doctor to see whether crystals (found in patients
with gout or other types of crystal-induced arthritis) or bacteria
or viruses (found in patients with infectious arthritis) are present
in the joint.
test measures the level of complement, a group of proteins in
the blood. Complement helps destroy foreign substances, such as
germs, that enter the body. A low blood level of complement is
common in people who have active lupus.
blood count (CBC)—This
test determines the number of white blood cells, red blood cells,
and platelets present in a sample of blood. Some rheumatic conditions
or drugs used to treat arthritis are associated with a low white
blood count (leukopenia), low red blood count (anemia), or low
platelet count (thrombocytopenia). When doctors prescribe medications
that affect the CBC, they periodically test the patient’s blood.
blood test is commonly ordered in patients who have rheumatic
diseases to monitor for underlying kidney disease.
sedimentation rate (sed rate)—This
blood test is used to detect inflammation in the body. Higher
sed rates indicate the presence of inflammation and are typical
of many forms of arthritis, such as rheumatoid arthritis and ankylosing
spondylitis, and many of the connective tissue diseases.
(PCV, packed cell volume)—This
test and the test for hemoglobin (a substance in the red blood
cells that carries oxygen through the body) measure the number
of red blood cells present in a sample of blood. A decrease in
the number of red blood cells (anemia) is common in people with
inflammatory arthritis and rheumatic diseases.
factor—This test determines whether rheumatoid factor
is present in the blood. Rheumatoid factor is an antibody found
in the blood of most (but not all) people who have rheumatoid
arthritis. Rheumatoid factor may be found in many other diseases
besides rheumatoid arthritis, and sometimes in normal, healthy
this test, a urine sample is studied for protein, red blood cells,
white blood cells, or casts. These abnormalities indicate kidney
disease, which may be seen in several rheumatic diseases such
as lupus or vasculitis. Some medications used to treat arthritis
can also cause abnormal findings on urinalysis.
blood cell count (WBC)—This test determines the number
of white blood cells present in a sample of blood. The number
may increase as a result of infection or decrease in response
to certain medications, or with certain diseases, such as lupus.
Low numbers of white blood cells increase a person’s risk of infections.
With Your Doctor To Limit Your Pain
you play in developing your treatment plan is very important.
It is vital for you to have a good relationship with your
doctor so that you can work together. You should not be afraid
to ask questions about your condition or treatment. You must
understand the treatment plan and tell the doctor whether
or not it is helping you. Studies have shown that patients
who are well informed and participate actively in their own
care experience less pain and make fewer visits to the doctor
than other patients do.
Rays and Other Imaging Procedures
To see what
the joint looks like inside, the doctor may order X rays or other
imaging procedures. X rays provide an image of the bones, but they
do not show the cartilage, muscles, and ligaments. Other noninvasive
imaging methods such as computed tomography (CT or CAT), magnetic
resonance imaging (MRI), and arthrography (joint X ray) show the
whole joint. The doctor may also use an arthroscope (a small, flexible
tube that transmits the image of the inside of a joint to a video
screen) to examine damage to a joint. The arthroscope is inserted
into the affected joint through a very small incision in the skin.
This procedure, called arthroscopy, allows the doctor to see inside
the joint. Doctors also use arthroscopy to perform surgery for some
types of joint injury.
Are the Treatments?
for arthritis include rest and relaxation, exercise, proper diet,
medication, and instruction about the proper use of joints and ways
to conserve energy. Other treatments include the use of pain relief
methods and assistive devices, such as splints or braces. In severe
cases, surgery may be necessary. The doctor and the patient work
together to develop a treatment plan that helps the patient maintain
or improve his or her lifestyle. Treatment plans usually combine
several types of treatment and vary depending on the rheumatic condition
and the patient.
Exercise, and Diet
have a rheumatic disease should develop a comfortable balance between
rest and activity. One sign of many rheumatic conditions is fatigue.
Patients must pay attention to signals from their bodies. For example,
when experiencing pain or fatigue, it is important to take a break
and rest. Too much rest, however, may cause muscles and joints to
can reduce joint pain and stiffness and increase flexibility, muscle
strength, and endurance. It also helps with weight reduction and
contributes to an improved sense of well-being. Before starting
any exercise program, people with arthritis should talk with their
doctor. People with arthritis can participate in a variety of sports
and exercise programs. Exercises that doctors often recommend include
exercises to help maintain normal joint movement, maintain
or increase flexibility, and relieve stiffness.
to maintain or increase muscle strength. Strong muscles help support
and protect joints affected by arthritis.
or endurance exercises to improve cardiovascular fitness,
help control weight, and improve overall well-being. Studies show
that aerobic exercise can also reduce inflammation in some joints.
part of a treatment program is a well-balanced diet. Along with
exercise, a well-balanced diet helps people manage their body weight
and stay healthy. Weight control is important to people who have
arthritis because extra weight puts extra pressure on some joints
and can aggravate many types of arthritis. Diet is especially important
for people who have gout. People with gout should avoid alcohol
and foods that are high in purines, such as organ meats (liver,
kidney), sardines, anchovies, and gravy.
A variety of
medications are used to treat rheumatic diseases. The type of medication
depends on the rheumatic disease and on the individual patient.
At this time, the medications used to treat most rheumatic diseases
do not provide a cure, but rather limit the symptoms of the disease.
The one exception is treatments for infectious arthritis. If caught
early enough, arthritis associated with an infection (such as Lyme
disease) can usually be cured with antibiotics.
commonly used to treat rheumatic diseases provide relief from pain
and inflammation. In some cases, the medication may slow the course
of the disease and prevent further damage to joints or other parts
of the body. This fact sheet describes the medications most commonly
used to treat pain and inflammation.
may delay using medications until a definite diagnosis is made,
because medications can hide important symptoms (such as fever and
swelling) and thereby interfere with diagnosis. Patients taking
any medication, either prescription or over-the-counter, should
always follow the doctor’s instructions. The doctor should be notified
immediately if the medicine is making the symptoms worse or causing
other problems, such as an upset stomach, nausea, or headache. The
doctor may be able to change the dosage or medicine to reduce these
(pain relievers) such as aspirin; other nonsteroidal anti-inflammatory
drugs (NSAID’s) such as ibuprofen (Motrin,¹
Advil, Nuprin); and acetaminophen (Tylenol) are used to reduce the
pain caused by many rheumatic conditions. Aspirin and NSAID’s have
the added benefit of decreasing the inflammation associated with
arthritis. Certain analgesics, such as aspirin and NSAID’s, can
have side effects, such as stomach irritation, that can be reduced
by changing the dosage or the medication. The dosage will vary depending
on the particular illness and the overall health of the patient.
The doctor and patient must work together to determine which analgesic
to use and the appropriate amount. If analgesics do not ease the
pain, the doctor may use other medications, depending on the diagnosis.
Brand names included in this fact sheet are provided as examples
only, and their inclusion does not mean that these products
are endorsed by the National Institutes of Health or any other
Government agency. Also, if a particular brand name is not mentioned,
this does not mean that the product is unsatisfactory.
such as prednisone, cortisone, solumedrol, and hydrocortisone, are
used to treat many rheumatic conditions because they decrease inflammation
and suppress the immune system. The dosage of these medications
will vary depending on the diagnosis and the patient; again, the
patient and doctor must work together to determine what dose is
best for the patient.
can be given by mouth, in creams applied to the skin, or by injection.
Short-term side effects of corticosteroids include swelling, increased
appetite, weight gain, and emotional ups and downs. These side effects
generally stop when the drug is stopped. It can be dangerous to
stop taking corticosteroids suddenly, so it is very important that
the doctor and patient work together when changing the corticosteroid
dose. Side effects that may occur after long-term use of corticosteroids
include stretch marks, excessive hair growth, osteoporosis, high
blood pressure, damage to the arteries, high blood sugar, infections,
rheumatic diseases respond to analgesics and corticosteroids, others
may not. Rheumatoid arthritis, gout, lupus, scleroderma, and fibromyalgia
are some of the rheumatic diseases that routinely require other
medications; these are prescribed to slow the course of the disease
or to treat disease-specific symptoms.
and Cold Therapies
Heat and cold
can both be used to reduce the pain and inflammation of arthritis.
Both therapies come in different forms, and the patient and doctor
can determine which form works best. Studies have shown heat and
cold therapies to be equally effective in reducing pain, although
they are usually avoided in acute gout.
increases blood flow, tolerance for pain, and flexibility. Heat
therapy can involve treatment with paraffin wax, microwaves, ultrasound,
or moist heat. Physical therapists are needed to apply paraffin
wax, or use microwave or ultrasound therapy, but patients can apply
moist heat themselves. Some ways to apply moist heat include placing
warm towels or hot packs on the inflamed joint or taking a warm
bath or shower.
numbs the nerves around the joint (which reduces pain) and relieves
inflammation and muscle spasms. Cold therapy can involve cold packs,
ice massage, soaking in cold water, or over-the-counter sprays and
ointments that cool the skin and joints.
Mobilization Therapy, and Relaxation Therapy
involves exercising or relaxing in warm water, which helps relax
tense muscles and relieve pain. Exercising in a large pool is easier
because water takes some weight off painful joints. This type of
exercise improves muscle strength and joint movement.
therapies include traction (gentle, steady pulling), massage, and
manipulation (using the hands to restore normal movement to stiff
joints). When done by a trained professional, these methods can
help control pain, increase joint motion, and improve muscle and
therapy helps reduce pain by teaching people various ways to release
muscle tension throughout the body. In one method of relaxation
therapy, known as progressive relaxation, the patient tightens a
muscle group and then slowly releases the tension. Doctors and physical
therapists can teach patients progressive relaxation and other relaxation
The most common
assistive devices for treating arthritis pain are splints and braces,
which are used to support weakened joints or allow them to rest.
Some of these devices prevent the joint from moving; others allow
some movement. A splint or brace should be used only when recommended
by a doctor or therapist, who will show the patient the correct
way to put the device on, ensure that it fits properly, and explain
when and for how long it should be worn. The incorrect use of a
splint or brace can cause joint damage, stiffness, and pain.
A person with
arthritis can use other kinds of devices to ease the pain. For example,
the use of a cane when walking can reduce some of the weight placed
on an arthritic knee or hip. A shoe insert (orthotic) can ease the
pain of walking caused by arthritis of the foot or knee.
be required to repair damage to a joint after trauma (a torn meniscus,
for example) or to restore function or relieve pain in a joint damaged
by arthritis. The doctor may recommend arthroscopic surgery, bone
fusion (surgery in which bones in the joint are fused or joined
together), or arthroplasty (also known as total joint replacement,
in which the damaged joint is removed and replaced with an artificial
About Treating Arthritis
At this time,
the only type of arthritis that can be cured is that caused by infections.
Although symptoms of other types of arthritis can be effectively
managed with rest, exercise, and medication, there are no cures.
Some people claim to have been cured by treatment with herbs, oils,
chemicals, special diets, radiation, or other products. However,
there is no scientific evidence that such treatments are helpful
in patients with arthritis and, moreover, they may actually cause
harm with the development of side effects. Patients should talk
to their doctor before using any therapy that has not been prescribed
or recommended by the health care team caring for the patient.
Can Be Done To Help?
that an estimated 18 percent of Americans who have arthritis or
other rheumatic conditions believe that their condition limits their
activities. People with arthritis may find that they can no longer
participate in some of their favorite activities, which can affect
their overall well-being. Even when arthritis impairs only one joint,
a person may have to change many daily activities to protect that
joint from further damage and reduce pain. When arthritis affects
the entire body, as it does in people with rheumatoid arthritis
or fibromyalgia, many daily activities have to be changed to deal
with pain, fatigue, and other symptoms.
the home may help a person with chronic arthritis continue to live
safely, productively, and with less pain. People with arthritis
may become weak, lose their balance, or fall in the bathroom. Installing
grab bars in the tub or shower and by the toilet, placing a secure
seat in the tub, and raising the height of the toilet seat can help.
Special kitchen utensils can accommodate arthritic hands to make
meal preparation easier. An occupational therapist can help people
who have rheumatic conditions identify and make adjustments in their
homes to create a safer, less painful, and more efficient environment.
family can help a patient with a rheumatic condition by learning
about that condition and understanding how it affects the patient’s
life. Friends and family can provide emotional and physical assistance.
Their support, as well as support from other people who have the
same disease, can make it easier to cope. The Arthritis Foundation
(see the list of resources at the end of this fact sheet) has a
wealth of information to help people with arthritis.
Is Some of the Current Research Being Done on Arthritis?
Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS),
a part of the National Institutes of Health (NIH), leads the Federal
medical research effort in arthritis and rheumatic diseases. The
NIAMS sponsors research and research training on the NIH campus
in Bethesda, Maryland, and at universities and medical centers throughout
the United States.
The NIAMS supports
three types of centers: Multipurpose Arthritis and Musculoskeletal
Diseases Centers (MAMDC’s), Specialized Centers of Research (SCOR’s),
and Core Centers.
foster a multidisciplinary approach to the many problems of arthritis
and musculoskeletal diseases and develop new capabilities for research
into other diseases. Centers develop and carry out research in basic
or laboratory and clinical science, professional and patient education,
and epidemiology and health services.
Each SCOR focuses
on a single disease: currently, rheumatoid arthritis, systemic lupus
erythematosus, osteoarthritis, osteoporosis, and scleroderma. By
doing laboratory and clinical studies under one roof, these centers
aim to speed up basic research on the causes of these diseases and
to hasten transfer of advances from the laboratory to the bedside
and improve patient care.
promote interdisciplinary collaborative efforts among scientists
engaged in high-quality research related to a common theme. By providing
funding for facilities, pilot and feasibility studies, and program
enrichment activities at the Core Center, the Institute reinforces
and amplifies investigations already ongoing in NIAMS program areas.
Core Centers are currently targeted for skin diseases (Skin Disease
Research Core Centers) and for musculoskeletal disorders (Core Centers
for Musculoskeletal Disorders).
NIAMS research efforts in rheumatoid arthritis, osteoarthritis,
lupus, and scleroderma are outlined below.
are trying to identify the causes of rheumatoid arthritis in the
hope that understanding the cause will lead to new treatments. They
are examining the role that the endocrine (hormonal), nervous, and
immune systems play, and the ways in which these systems interact
with environmental and genetic factors in the development of rheumatoid
arthritis. Some scientists are trying to determine whether an infectious
agent triggers rheumatoid arthritis. Others are studying the role
of certain enzymes (specialized proteins in the body that carry
out biochemical reactions) in breaking down cartilage. Researchers
are also trying to identify the genetic factors that place some
people at higher risk than others for developing rheumatoid arthritis.
are looking at new ways to treat rheumatoid arthritis. They are
experimenting with new drugs and “biologic agents” that selectively
block certain immune system activities associated with inflammation.
Recent studies suggest that these represent promising approaches
to treatment. Other investigators have shown that minocycline and
doxycycline, two antibiotic medications in the tetracycline family,
have a modest benefit for people with rheumatoid arthritis.
are working to understand what role certain enzymes play in the
breakdown of joint cartilage in osteoarthritis and are testing drugs
that block the action of these enzymes. In addition, a gene that
may be linked to an inherited form of osteoarthritis has recently
are looking at how genetic, environmental, and hormonal factors
influence the development of systemic lupus erythematosus. They
are trying to find out why lupus is more common in certain populations.
There has been very promising progress in identifying the genes
that may be responsible for lupus. Promising areas of treatment
research include biologic agents; newer, more selective drugs that
suppress the immune system; and efforts to correct immune abnormalities
with bone marrow transplantation. Clinical studies are underway
to determine the safety of estrogens for hormone replacement therapy
and birth control in women with lupus. Contrary to the widely held
belief that estrogens can make the disease worse, recent data suggest
that these drugs may be safe for some women with lupus.
on scleroderma are focusing on three areas of the disease: overproduction
of collagen, blood vessel injury, and abnormal immune system activity.
Researchers hope to discover how these three elements interact with
each other to cause and promote scleroderma. In one recent study,
researchers found evidence of fetal cells within the blood and skin
lesions of women who had been pregnant years before developing scleroderma.
The study suggests that fetal cells may play a role in scleroderma
by maturing immune cells that promote the overproduction of collagen.
Scientists are continuing to study the implications of this finding.
Can People Find More Information About Arthritis?
1330 West Peachtree Street
Atlanta, GA 30309
800/283–7800, or call your local chapter (listed in the telephone
World Wide Web address: http://www.arthritis.org/
This is the
main voluntary organization devoted to arthritis. The foundation
publishes free pamphlets on many types of arthritis and a monthly
magazine for members that provides up-to-date information on arthritis.
The foundation also can provide physician and clinic referrals.
College of Rheumatology/Association of Rheumatology
1800 Century Place, Suite 250
Atlanta, GA 30345–4300
World Wide Web address: http://www.rheumatology.org/
provides referrals to rheumatologists and physical and occupational
therapists who have experience working with people who have rheumatic
diseases. The organization also provides educational materials and
guidelines about many different rheumatic diseases.
Arthritis and Musculoskeletal and
Skin Diseases Information Clearinghouse (NAMSIC)
National Institutes of Health
1 AMS Circle
Bethesda, Maryland 20892–3675
NIAMS Fast Facts–For health information that is available by fax
24 hours a day,
call 301/881–2731 from a fax machine telephone.
World Wide Web address: http://www.nih.gov/niams/
a public service sponsored by the NIAMS, provides information about
various forms of arthritis and rheumatic disease. The clearinghouse
distributes patient and professional education materials and also
refers people to other sources of information.
The NIAMS gratefully
acknowledges the assistance of John H. Klippel, M.D., and Reva Lawrence
of NIAMS; Barri Fessler, M.D., of the Cleveland Clinic Foundation;
and Eric Matteson, M.D., of the Mayo Clinic, in the review of this
medication or treatment that relieves pain.
A rheumatic disease that causes arthritis of the spine and sacroiliac
joints and, at times, inflammation of the eyes and heart valves.
proteins produced by the body’s immune system that help fight
and destroy viruses, bacteria, and other foreign substances
(antigens) that invade the body. Occasionally, abnormal antibodies
develop that can attack a part of the body and cause autoimmune
disease. These abnormal antibodies are called autoantibodies.
foreign substance that stimulates an immune response.
x-ray procedure that provides a detailed image of the joint
when air or a contrast substance is injected into the joint
procedure performed with an arthroscope (a small, flexible tube
that transmits the image of the inside of a joint to a video
monitor). Arthroscopy is used for diagnosis as well as treatment
of some types of joint injury. The arthroscope is inserted through
a small incision in the skin near the affected joint.
small sac of tissue located between bone and other moving structures
such as muscles, skin, or tendons. The bursa contains a lubricating
fluid that allows smooth gliding between these structures.
condition involving inflammation of the bursae.
resilient tissue that covers and cushions the ends of the bones
and absorbs shock.
main structural protein of skin, bones, tendons, cartilage,
and connective tissue.
supporting framework of the body and its internal organs.
tomography (CT or CAT):
diagnostic technique that uses a computer and an x-ray machine
to take a series of images that can be transformed into a clear
and detailed image of a joint.
anti-inflammatory hormones that are made naturally in the body
or synthetically for use as drugs. The most commonly prescribed
drug of this type is prednisone.
chronic disorder characterized by widespread musculoskeletal
pain, fatigue, and tenderness in localized areas of the neck,
spine, shoulders, and hips called “tender points.”
tough wrapping of tendons and ligaments that surrounds the joint.
type of arthritis resulting from deposits of needle-like crystals
of uric acid in the connective tissue, joint spaces, or both.
that takes place in water.
of arthritis caused by infectious agents, such as bacteria or
typical reaction of tissue to injury or disease. It is marked
by four signs: swelling, redness, heat, and pain.
place where two or more bones are joined. Most joints are composed
of cartilage, joint space, fibrous capsule, synovium, and ligaments.
area enclosed within the fibrous capsule and synovium.
term used to refer to the types of arthritis that affect children.
Juvenile rheumatoid arthritis is the most common type.
bands of cordlike tissues that connect bone to bone.
type of immune disorder known as an autoimmune disease that
can lead to inflammation of and damage to joints, skin, kidneys,
heart, lungs, blood vessels, and brain.
disease caused by the bacterium Borrelia burgdorferi
in which arthritis is often a prominent symptom. Rash, heart
disease, and nervous system involvement may also occur.
resonance imaging (MRI):
diagnostic technique that provides high-quality cross-sectional
images of a structure of the body without X rays or other radiation.
treatment by which health professionals use their hands to help
restore normal movement to stiff joints.
type of deep heat therapy in which electromagnetic waves pass
between electrodes placed on the patient’s skin. This therapy
creates heat that increases blood flow and relieves muscle and
group of treatments that include traction, massage, and manipulation.
When performed by a trained professional, these methods can
help control a patient’s pain and increase joint and muscle
anti-inflammatory drugs (NSAID’s):
group of medications, including aspirin, ibuprofen, and related
drugs, used to reduce inflammation that causes joint pain, stiffness,
type of arthritis that causes the cartilage in the joints to
fray and wear. In extreme cases, the cartilage may wear away
rheumatic disease that involves tendons, muscles, ligaments,
and tissues around the joints. Pain, aching, and morning stiffness
in the neck, shoulders, lower back, and hips characterize the
disease. It is sometimes the first sign of giant cell arteritis
(a disease of the arteries characterized by inflammation, weakness,
weight loss, and fever).
rheumatic disease that causes weakness and inflammation of muscles.
inflammation that occurs in about 5 to 10 percent of people
with psoriasis (a common skin disorder).
form of arthritis that develops after an infection involving
the lower urinary tract, bowel, or other organs.
term referring to a disorder or condition that causes pain or
stiffness in the joints, muscles, or bone.
inflammatory disease of the synovium, or lining of the joint,
that results in pain, stiffness, swelling, deformity, and loss
of function in the joints.
doctor who specializes in diagnosing and treating disorders
that affect the joints, muscles, tendons, ligaments, and bones.
that increases a person’s chance of developing a disease, such
as age, gender, ethnicity, and genetics (family history).
disease of the connective tissues and blood vessels that leads
to hardening of the skin. Scleroderma can also damage internal
organs such as the kidneys, lungs, heart, or gastrointestinal
released into movable joints by surrounding membranes. The fluid
lubricates the joint and reduces friction.
thin membrane that lines a joint and releases a fluid that allows
the joint to move easily.
of tendons caused by overuse, injury, or related rheumatic conditions.
fibrous cords of tissue that connect muscle to bone.
treatment that uses sound waves to provide deep heat and relieve
Institute of Arthritis and Musculoskeletal and Skin Diseases
(NIAMS), a part of the National
Institutes of Health (NIH), leads the Federal medical research
effort in arthritis and musculoskeletal and skin diseases. The
NIAMS supports research and research training throughout the
United States, as well as on the NIH campus in Bethesda, MD,
and disseminates health and research information. The National
Arthritis and Musculoskeletal and Skin Diseases Information
Clearinghouse (NAMSIC) is a public service sponsored by the
NIAMS that provides health information and information sources.
Additional information can be found on the NIAMS Web site at