Arthrosis and Rheumatoid Arthritis

Artrosi e artrite reumatoide

Arthritis is a chronic and systemic inflammatory disease triggered by a malfunction of the immune system, which starts attacking parts of the body itself, particularly joints and connective tissues. Arthritis usually first appears between the ages of 35 and 50, but it can develop at any time in life, even in youth, for reasons which are not entirely clear. This condition can be very aggressive, often referred to as "arthritic attacks," leading to rapid joint destruction and significantly impacting daily life.

There are various types of arthritis, such as gouty arthritis or gout, characterized by "tophi," especially in the area of the big toe, or psoriatic arthritis, typically found in individuals with psoriasis. However, the most well-known form of this disease is rheumatoid arthritis, which affects about 1% of the global population, regardless of ethnicity or country of origin.


Causes and Diagnosis

Arthritis, as mentioned, can develop at any point in life, but a definitive cause has not been established. It is believed that the onset and progression of the disease are influenced by a combination of environmental, genetic, hormonal, and infectious factors. For example, individuals with immunodeficiencies exposed to chronic stress and anxiety-inducing stimuli are more prone to developing arthritis. Certain viral infections like herpes, obesity, and smoking can also contribute to its onset.

Diagnosis is primarily based on symptoms, as well as blood tests that look for specific antibodies. The most significant antibodies include Rheumatoid Factor (present in about 80% of cases) and Anti-Cyclic Citrullinated Peptide (present in 60-80% of cases, with a specificity of 98%). The latter is crucial because it can be present in the early stages of the disease, even before joint inflammation becomes evident, and it indicates a higher likelihood of developing radiologically significant damage.

Other investigational tests, mainly useful for staging the disease and assessing joint damage, include X-rays and ultrasound.


Effects on the Body

As mentioned, arthritis is caused by an "error" in our immune system: antibodies, which usually defend our body, become abnormally activated and attack our own tissues covering joints, as well as organs and blood vessels. The initial symptoms are joint pain, swelling, and stiffness, and other symptoms like fever, weakness, and organ damage can also occur. The disease's progression can vary greatly, leading to cartilage and joint erosion, making them painful and unstable. In some cases, such as in the hands, joints can even deform. 

The main symptoms of Rheumatoid Arthritis indicate joint inflammation, similar to what happens in osteoarthritis. This is why the two conditions are often mistaken and confused, despite their significant differences.


Osteoarthritis and Rheumatoid Arthritis: Differences

In common language, the two terms are sometimes used interchangeably, but they are fundamentally distinct conditions. Understanding the difference is crucial for guiding the diagnostic process. Unfortunately, one condition doesn't exclude the other, so both forms can coexist, complicating the picture of painful symptoms and movement difficulties. What are the differences?

- Heredity: Osteoarthritis has a strong genetic component, often passed down through generations, particularly in the female lineage. Family predisposition is one of the main risk factors for the development of osteoarthritis. In contrast, rheumatoid arthritis is not hereditary and can manifest in any family member.

- Age: Osteoarthritis is a form of joint degeneration linked to ageing and typically starts around 40-45 years of age. Rheumatoid arthritis, on the other hand, results from immune system dysfunction that can occur at any age, even during youth.

- Prevalence: Osteoarthritis affects over 5 million people in Italy alone, predominantly women. Rheumatoid arthritis affects around 350,000 people in Italy, a much smaller percentage, and it also affects men. In terms of the body, osteoarthritis primarily affects the finger joints, knees, and hips, often developing gradually. Rheumatoid arthritis damages all joints, including shoulders, spine, and even the jaw, sometimes rapidly and unexpectedly. It can also affect organs and the vascular system.


When the Hands Are Affected

Both osteoarthritis and rheumatoid arthritis impact various joints, both large and small. However, the hands are particularly vulnerable to these conditions. As mentioned earlier, the symptoms are similar, involving redness, swelling, pain, and joint stiffness. Therefore, it can sometimes be challenging to differentiate between the two diseases, except for their localization: osteoarthritis typically affects the trapeziometacarpal joint (the base of the thumb) and the distal interphalangeal joints (the joints closest to the nails). Rheumatoid arthritis usually presents symmetrically, affecting the metacarpophalangeal and proximal interphalangeal joints, the two joints farthest from the nails. In cases of arthritis affecting the fingers, joints can rapidly deform, become locked in position, lose the ability to flex or extend, and even move out of their natural alignment. For instance, when the fingers deviate outward and the pinky finger points, it's referred to as "wind-swept deformity." When the joint at the base of a finger bends inward, the middle joint extends, and the end joint bends inward, it's known as "swan-neck deformity."


Prevention and Treatment

There is no definitive cure for arthritis, primarily due to the unknown causes underlying its development. Therefore, the goal of treatment is to reduce symptoms and halt damage before joints suffer irreversible harm. The medications commonly used to alleviate pain and inflammation, such as NSAIDs and corticosteroids, have numerous side effects and contraindications, especially with prolonged use, making them unsuitable for long-term solutions. However, adopting healthy habits to avoid risk factors like obesity and smoking, along with preserving joint well-being through physical activity and the assistance of a skilled physiotherapist, can be beneficial. 

Just as with osteoarthritis, an anti-inflammatory diet and specific joint supplements play a vital role in reducing joint inflammation and assisting in managing arthritis.

Libro dieta anti artosi - Algosfree


An anti-inflammatory diet and the use of specific supplements for the joints, it is fundamental in reducing joint inflammation and managing arthritis as it is for the arthrosis.


Read also Rizoartrosi and vitamina D 

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