Osteoarthritis , also called degenerative joint disease. 

Men and women are affected equally before the age of 55, but there is a higher incidence of osteoarthritis in women over 55. 

Ninety percent of people over 60 show some signs of osteoarthritis. 

When the cause of osteoarthritis is unknown, it is called primary osteoarthritis.

When the cause is known, such as injury, and repeated use of the joint (such as the shoulder and elbow joints of baseball pitchers), it is called secondary osteoarthritis.

Bony spurs develop around the joint, and pain and inflammation result.

Osteoarthritis is diagnosed based on the patient's medical history, a physical examination to determine which joints are affected, blood tests, and x-rays. 

A sample of synovial fluid from the affected joint may also be taken. 

The main symptom of osteoarthritis is restricted motion in the joint, along with a deep, aching pain during movement and at night, and joint deformity.

The condition usually begins with pain after exercise or use of the joint. 

Includes rest of the joints that are affected, heat, and anti-inflammatory drugs. 

Injections of adrenal hormone drugs into the joint may give relief. 

Surgery is sometimes necessary and may reduce pain and greatly improve the working of a joint. 

Replacing the hip and fusing the parts of the joint are some of the kinds of surgery that are used in treating serious cases of osteoarthritis. 

It is also called arthritis deformans, atrophic arthritis. 

Rheumatoid arthritis is a chronic disease, meaning that those who have it must live with it the rest of their lives. 

Rheumatoid arthritis affects children between 8 and 15 years of age and adults between 25 and 55 years of age. 

Rheumatoid arthritis most commonly, first appears in early middle age, between 36 and 50 years of age. 

It rarely occurs in those over 55. 

It is two to three times more common in women than in men, and it has a tendency to run in families. 

Seventy percent of the people affected are over 30 years of age.

The cause of rheumatoid arthritis is unknown. A possible explanation is that it is an autoimmune (or self-immune) disorder, which means that the body is attacking itself, especially the lining of the joints. An infectious agent also could be a cause. 

Rheumatoid arthritis affects the smaller joints of the hands, wrists, feet, and ankles before it affects joints such as the hips, knees, and elbows. 

The disease is symmetric and bilateral, meaning that it affects the same joints on both sides of the body.

Rheumatoid arthritis affects the synovium, the lining of the joints, which becomes inflamed (red, swollen, painful, and warm) as if reacting to an infection. 

The synovium secretes more synovial fluid, making the joint more swollen.. 

This leads to thickening of the synovial membrane and swelling of the joint.

Later, the cartilage also becomes involved and eventually becomes rough and pitted.

Ligaments and tendons also become inflamed, scarred, and shortened by the disease, contributing to the deformities often noticed in the hands and wrists of people with rheumatoid arthritis.

The course of the disease varies. 

There are times when it goes away (remission), and times when it gets worse (exacerbations).

Rheumatoid arthritis is not always progressive or deforming. Thus, early treatment may help the patient to recover and perhaps to avoid future attacks.

The main symptoms of rheumatoid arthritis are pain and loss of function in the joints.

Other symptoms include morning stiffness in one or more joints, warmth in the joints, swelling in at least one or two joints, a tingling or prickling sensation in the hands or feet, tiredness, weight loss, and a feeling of ill health.

As the disease progresses, nodules form under the skin, cysts (water-filled masses) develop in the synovium and bone, and the joints and surrounding bone and tissue become deformed.

Rheumatoid arthritis is diagnosed based on the symptoms, a physical examination, x-rays, blood tests, and other laboratory tests.

Rheumatoid factor (RF) is in blood and synovial fluid of most patients with rheumatoid arthritis. Higher amounts are found in the more severe forms of the disease.

The basic treatment is rest,

Exercise to help joint function, 

Drugs for pain relief and lowering the swelling, 

Surgery to prevent or correct defects, and a 

Good diet-with weight loss, if needed. 

Aspirin-type drugs are given.

If the patient does not get better, other anti swelling drugs may be used. Steroids are given with caution because of side effects. These are peptic ulcer, slowed adrenal glands, and bone weakening (osteoporosis). 

Other treatments, as diathermy, ultrasound, warm paraffin applications, and exercise under water are used. 

Also called Marie-Strumpell disease. 

A long-term swelling disease of unknown cause. 

It first affects the spine and nearby structures. 

It often progresses to a joining together (ankylosis) of the bones of the spinal column. 

In extreme cases the patient stoops forward, which is called a "poker spine" or "bamboo spine." 

The disease affects mostly men under 30 years of age. 

There is a strong chance that it can be inherited. 

As well as the spine, the joints of the hip, shoulder, neck, ribs, and jaw are often involved.

When the joints where the ribs join the spine are involved, it may be hard for the patient to expand the rib cage while breathing. 

Many patients with the disease also have bowel disease that involves swelling, heat, redness, and pain. 

The aim of treatment is to relieve pain and swelling in the joints, usually with drugs. 

Physical therapy aids in keeping the spine as erect as possible. 

In advanced cases surgery may be done to straighten a badly bent spine. 

or gouty arthritis, a state of hyperuricemia, a disease of uric acid processing. 

A primary or secondary recurrent, acute arthritis of the peripheral joints, particularly the great toe.

It increases production or interferes with the passing of uric acid.

Excess uric acid is converted to sodium urate crystals that settle into joints and other tissues.

Men are more often affected than women. 

The great toe is a common site for the buildup of urate crystals. 

The condition can result in painful swelling of a joint, along with chills and fever.

The disease is crippling and, if untreated, can lead to joint breakdown.

The precise causal mechanism in gout is unknown. 

However, a host of factors act as precursors to overproduction or under secretion of uric acid, including genetic factors (hyperactivity of hypoxanthine guanine phosphoribosyl transferase, superactivity of phosphoribosyl pyrophosphate, fructose intolerance); environmental factors (ethanol abuse, diuretic use, severe muscle exertion); underlying disease processes (diabetes mellitus, polycythemia, hypertension, renal disease, leukemia, sickle cell anemia); and the evolutionary absence of the enzyme uricase. 

Gout occurs most often in men. 

Gout is rare in women before menopause. 

The incidence of gout is increasing in developed countries.

Some factor triggers an overproduction or under secretion of uric acid. 

The plasma becomes supersaturated with uric acid, and a crystal urate precipitate is formed and deposited in avascular tissues (e.g., cartilage, tendons, and ligaments of peripheral joints) and in cooler tissues (e.g., the ears). 

Through some undefined mechanism, the crystals are released at various times, causing an acute inflammatory reaction in the joint with extension to the periarticular tissues. 

Repeated acute attacks lead to chronic arthritis and deformed joints.

Acute pain, redness, swelling, tenderness, and heat at the affected joint are typical presenting features.

Fever, chills, and malaise may also be present. 

Limited motion is present in the affected joint or joints.

Treatment is aimed at terminating the acute attack and 

Preventing future attacks by lowering uric acid levels and resolving existing deposits.