Arthritis and Rheumatic Disease

What Are Rheumatic Diseases and What Is Arthritis?

There are 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.

Many people 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 next page.

Examples of Rheumatic Diseases

• Osteoarthritis—Also 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 hips).
• Rheumatoid arthritis—Rheumatoid 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 arthritis.
• Fibromyalgia—Fibromyalgia 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.
• Systemic lupus erythematosus—Systemic 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. .
• Scleroderma—Also 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.
• Juvenile rheumatoid arthritis—This 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.
• Ankylosing 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.
• Gout—This 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.
• Infectious arthritis—This 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.
• Reactive 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.
• Psoriatic arthritis—This 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.
• Bursitis—This 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.
• Tendinitis (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.

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