Arthritis: How is it diagnosed and is it reversible?

Arthritis starts with discomfort or pain in the joints, followed by stiffness, and gradually the range of motion starts getting restricted, says Dr. Abhishek Kumar Mishra, an orthopaedic and joint replacement surgeon at the Apollo Spectra Hospital in New Delhi. It is also not reversible, and the aim of treatment is to not let it get worse.

According to the World Health Organisation (WHO), rheumatoid arthritis, a chronic condition that affects the joints, connective tissues, muscle, tendons, and fibrous tissue, can happen between the ages of 20 and 40. Whereas, osteoarthritis, a degenerative joint disease, “will most likely affect the joints that have been continually stressed throughout the years including the knees, hips, fingers, and lower spine region”.

Dr Mishra speaks to Femoai about the incidence of the two main types of arthritis — osteoarthritis and rheumatoid arthritis — in women, their symptoms, diagnosis, and why is it not reversible. Edited excerpts:

• The incidence of arthritis is higher in women, why is that?
• Talk to us about some of the symptoms of arthritis and how is it diagnosed?
• How is arthritis diagnosed?
• Is arthritis reversible?

The incidence of arthritis is higher in women, why is that?

Women are more likely to get arthritis as compared to men; this is scientifically proven, and it is true for about rheumatoid arthritis and degenerative arthritis or osteoarthritis. No one knows the exact cause, it is possibly an interplay of hormones. There is only one kind of arthritis, spondyloarthropathy (or spondyloarthritis), which impacts the spine and the joints (spondylitis is a type of  spondyloarthropathy), which is seen more in men as compared to women.

Talk to us about some of the symptoms of arthritis, and how is it diagnosed?

It starts with a bit of discomfort or pain, and then the patient may start developing stiffness, gradually the range of motion starts getting restricted. In a later stage, the patient may even develop a cracking sound from the joints. They might not be able to perform activities like low sitting or stair climbing. All these symptoms suggest arthritis.

Inflammatory arthritis tends to be very acute. It has a shorter duration; it becomes active very quickly. Osteoarthritis or degenerative arthritis has a prolonged course, it isn’t that the patient will start seeing symptoms and the joint will become very bad within six months. It takes years for the joint to become very bad. It has a waxing and waning course. It might be fine for a few months, but the pain and discomfort will reappear.

How is arthritis diagnosed?

The diagnosis is on the basis of a simple x-ray. X-rays are very pertinent in these conditions. There is no need to go for fancy investigations like MRI or CT scan to check whether the patient has arthritis or not. For osteoarthritis just an x-ray is sufficient, but for inflammatory arthritis, you will also need a blood test. For example, for rheumatoid arthritis, we need a rheumatoid factor (RF) test and an anti-cyclic citrullinated peptide (anti-CCP) antibody test. For spondylitis and spondyloarthropathy, we need a HLA-B27 (Human Leukocyte Antigen B27) blood test.

 Is arthritis reversible?

Osteoarthritis basically involves degeneration of the cartilage. it is the gel or the lubricating layer within two bones in the joint. Unfortunately, medical science has not developed a way to reverse the degeneration to a great extent. Let me be very direct with you, cartilage regeneration is extremely difficult or almost impossible. The focus of treatment is to not let it get worse. If at all it is getting worse, it should not go downhill at a very rapid pace, that is what we hope to achieve with treatment.

Cartilage regeneration is extremely difficult or almost impossible. The focus of treatment is to not let it get worse.

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